Atopic dermatitis activity is not associated with cardiovascular risk

1. In this cohort study, more active or severe atopic dermatitis (AD) in children was not associated with a greater cardiovascular risk. 

Evidence Rating Level: 2 (Good)

Children with atopic dermatitis (AD) may be at increased risk for cardiovascular disease (CVD) later in life. Still, existing research has been inconsistent and often limited by cross‑sectional designs and inadequate adjustment for key factors like BMI. Because childhood cardiovascular risk factors, such as high blood pressure, abnormal lipids, obesity, and early signs of atherosclerosis, strongly predict adult cardiovascular disease, understanding whether AD contributes to these risks is important. This study set out to determine whether children with AD have higher rates of cardiometabolic risk factors and whether more active or severe AD across childhood is linked to early signs of atherosclerosis in young adulthood. Active atopic dermatitis was measured repeatedly from infancy through adolescence using a standardized question about itchy, dry rash in typical flexural areas, with active AD defined as at least two positive reports across assessments. Cardiovascular risk was also assessed repeatedly from early childhood through young adulthood using standardized measures, including blood pressure, BMI, and plasma lipid levels. A total of 9281 children (4612 [49.69%] female) were included in the study. AD affected 13.10% to 21.58% of participants between ages 3 and 18, with 3.52% to 6.85% reporting moderate or severe disease. Across multiple ages, multivariable models showed no consistent associations between active AD and cardiovascular risk factors. The only statistically significant findings were two inconsistent associations with LDL cholesterol at ages 3 years (−0.33 SD; 95% CI −0.58 to −0.07) and 10 years (0.14 SD; 95% CI 0.03 to 0.24). Furthermore, there was no association between children with more persistent or severe AD and increased likelihood of showing early signs of subclinical atherosclerosis as they entered adulthood. Overall, these results indicate that routine cardiovascular screening for all children with AD is unlikely to provide additional benefit in identifying those at elevated early-life cardiovascular risk.

Click here to read this study in JAMA Network Open

Image: PD

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