Background Several studies have found a higher rate of hypertension among patients with psoriasis and psoriatic arthritis (PsA) versus the general population. This frequency may be even higher in patients with PsA compared to those with psoriasis alone1. Risk factors linked to the development of hypertension in PsA are unknown.
Objectives To analyze the clinical profile and risk factors linked to hypertension in subjects with PsA.
Methods Retrospective cohort study including 205 patients with PsA (CASPAR criteria) followed in a single university center. Cohort comprised by 112 men and 93 women, mean age 53±12.9 years. Average duration of psoriasis of 22±10.2 years and 14±8.9 years for arthritis. The following variables were included in all patients: age of onset of psoriasis and PsA, educational level, type and location of psoriasis, form of onset of PsA, evolutionary pattern, enthesitis, nail disease, DIP involvement, dactylitis, erosions, HLA-B27 and C*06, BMI, NSAID/GC and systemic therapy. Univariate and multivariate analyses were performed.
Results Sixty three of the 205 subjects had hypertension (30.7%). There was no difference in the frequency of hypertension between men and women. In univariate analysis, factors related to hypertension were low educational level (p<0.0001), pustular psoriasis (p=0.040), polyarticular onset (p=0.012), polyarticular evolution (p=0.040), onset of psoriasis ≥40 years (p<0.001), onset of arthritis ≥40 years (p=0.004) and obesity (p=0.001). However, in the multivariate analysis the only factor linked to hypertension risk was age (OR 1.12, 95% CI: 1.07-1.18).
Conclusions Hypertension is common among patients with PsA. Some clinical features of the disease linked to its inflammatory burden (polyarticular forms), social status (low educational level) or other comorbidities (obesity), seem to increase this risk. In any case it seems that the main determinant of this comorbidity is the age of patients (risk increase with age).
Miller IM, Ellervik C, Yazdanyar S, Jemec GB. Meta-analysis of psoriasis, cardiovascular disease, and associated risk factors. J Am Acad Dermatol. 2013 Dec;69(6):1014-24.
Disclosure of Interest None declared
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