Severe psoriasis linked with poorly controlled blood pressure

1. Psoriasis severity was associated with an increased likelihood of uncontrolled hypertension.

Evidence Rating Level: 2 (Good)

Study Rundown: Psoriasis is a common chronic inflammatory disease in which changes in cell turnover cause the formation of thick scaly plaques on the skin. Previous studies have demonstrated increased risk for cardiovascular disease in patients with psoriasis. The authors of this study aimed to assess the relationship of varying degrees of psoriasis on blood pressure (BP) control. Amongst patients with previously diagnosed hypertension (HTN, high blood pressure), there was a positive dose-response relationship between psoriasis severity and poorly controlled BP. While the study’s strength was its large cohort, the outcome of “uncontrolled HTN” was made after only a single BP measurement rather than an aggregate of multiple readings, which may have limited the study’s accuracy. Future studies are needed to better elucidate the pathophysiology linking blood pressure and psoriasis.

Click to read the study in JAMA Dermatology

Relevant Reading: Hypertension, Antihypertensive Medication Use, and Risk of Psoriasis

In-Depth [cross-sectional study]: 1322 patients were chosen from The Health Improvement Network (THIN) database; they were aged 25-64 and carried a diagnosis of both HTN and psoriasis. 11,977 age- and practice-matched controls also with HTN but without psoriasis were selected for comparison. 51.4%, 35.3%, 13.1% of the psoriasis cohort had mild, moderate, or severe disease, respectively. After accounting for confounders including age, sex, body mass index, duration of HTN, HTN severity and treatment, history of cyclosporine or corticosteroid use, the authors found a statistically significant association between psoriasis severit and uncontrolled HTN ≥140/90 (adjusted odds ratio (aOR) 0.97; 95% CI, 0.82-1.14 for mild psoriasis; and aOR, 1.48; 95% CI, 1.08-2.04 for severe psoriasis; P = .01).

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