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Penn researchers find psoriasis patients at increased risk for heart attack
October 11, 2006Risk higher for younger patients with severe psoriasis
(Philadelphia, PA)-Psoriasis is an independent risk factor for myocardial infarction (MI; heart attack), and this risk is greatest in young patients with severe psoriasis, according to Joel M. Gelfand, MD, MSCE, Assistant Professor of Dermatology, University of Pennsylvania School of Medicine, and lead author of the study that appears in the October 11 issue of The Journal of the American Medical Association (JAMA).
Psoriasis is a common, chronic immune-mediated disease that affects about 2% to 3% of the population. The disease is associated with markers of systemic inflammation, and the immunological abnormalities that lead to the development of psoriasis suggest that these patients may be at increased risk for other diseases associated with an inflammatory state.
"Several hospital-based studies have indicated that psoriasis is associated with a higher prevalence of cardiovascular diseases, including MI," said Gelfand. "However, these studies did not control for any associated risk factors for MI."
Gelfand and colleagues conducted a perspective population-based cohort study to determine the risk of heart attack in patients with psoriasis when controlling for major cardiovascular risk factors. The study data was collected from 1988-2002 by more than 500 general practitioners in the United Kingdom who were unaware of the hypothesis being tested.
The data was collected as part of the patient's electronic medial record and maintained in the General Practice Research Database.
The study population consisted of psoriasis patients aged 20-90. Among these patients, 127,139 were defined as having mild psoriasis and 3,831 patients were defined as having severe psoriasis. Adjustments were made for hypertension, diabetes, history of heart attack, hyperlipidemia (an excess of fats or lipids in the blood), age, sex, smoking, and body mass index. Each patient was matched to up to five control subjects who did not have psoriasis. These 556,995 control subjects were seen in the same practice during similar time periods.
The study revealed that the incidence of heart attack was higher in patients with severe psoriasis (5.13 MIs per 1,000 person-years) and mild psoriasis (4.04 MIs per 1,000 person-years) compared with control patients (3.58 MIs per 1,000 person-years). Younger patients with severe psoriasis had the highest relative risk of heart attack. For example, a 40-year-old patient with mild psoriasis had a 20 percent greater risk of having a heart attack than a patient without psoriasis; a 40-year-old patient with severe psoriasis had more than double the risk. A 60-year-old patient with severe psoriasis had a 36 percent increased risk for heart attack. The authors write that the magnitude of association between severe psoriasis and MI in those less than 50 years of age is similar to the magnitude of association for other major cardiac risk factors.
"Our findings are novel and therefore it is important that additional studies be performed to confirm these results and determine their therapeutic implications," write the authors. They recommend that in the meantime, as part of good medical care, patients with psoriasis should be encouraged to aggressively address their modifiable cardiovascular risk factors.
University of Pennsylvania School of Medicine
"Several hospital-based studies have indicated that psoriasis is associated with a higher prevalence of cardiovascular diseases, including MI," said Gelfand. "However, these studies did not control for any associated risk factors for MI."
Gelfand and colleagues conducted a perspective population-based cohort study to determine the risk of heart attack in patients with psoriasis when controlling for major cardiovascular risk factors. The study data was collected from 1988-2002 by more than 500 general practitioners in the United Kingdom who were unaware of the hypothesis being tested.
The data was collected as part of the patient's electronic medial record and maintained in the General Practice Research Database.
The study population consisted of psoriasis patients aged 20-90. Among these patients, 127,139 were defined as having mild psoriasis and 3,831 patients were defined as having severe psoriasis. Adjustments were made for hypertension, diabetes, history of heart attack, hyperlipidemia (an excess of fats or lipids in the blood), age, sex, smoking, and body mass index. Each patient was matched to up to five control subjects who did not have psoriasis. These 556,995 control subjects were seen in the same practice during similar time periods.
The study revealed that the incidence of heart attack was higher in patients with severe psoriasis (5.13 MIs per 1,000 person-years) and mild psoriasis (4.04 MIs per 1,000 person-years) compared with control patients (3.58 MIs per 1,000 person-years). Younger patients with severe psoriasis had the highest relative risk of heart attack. For example, a 40-year-old patient with mild psoriasis had a 20 percent greater risk of having a heart attack than a patient without psoriasis; a 40-year-old patient with severe psoriasis had more than double the risk. A 60-year-old patient with severe psoriasis had a 36 percent increased risk for heart attack. The authors write that the magnitude of association between severe psoriasis and MI in those less than 50 years of age is similar to the magnitude of association for other major cardiac risk factors.
"Our findings are novel and therefore it is important that additional studies be performed to confirm these results and determine their therapeutic implications," write the authors. They recommend that in the meantime, as part of good medical care, patients with psoriasis should be encouraged to aggressively address their modifiable cardiovascular risk factors.
University of Pennsylvania School of Medicine
Psoriasis Current Events and Psoriasis News RSSMultiple health concerns surface as winter, vitamin D deficiences arrive
A string of recent discoveries about the multiple health benefits of vitamin D has renewed interest in this multi-purpose nutrient, increased awareness of the huge numbers of people who are deficient in it, spurred research and even led to an appreciation of it as "nature's antibiotic."
Curry-cure? Spicing up the effectiveness of a potential disease-fighter
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Skin-disease patients show brain immunity to faces of disgust
People with psoriasis - an often distressing dermatological condition that causes lesions and red scaly patches on the skin - are less likely to react to looks of disgust by others than people without the condition, new research has found.
Gene variation is 'major genetic determinant of psoriasis'
A specific genetic region that has been increasingly identified as the strongest genetic link to psoriasis has an even more significant role in the chronic skin disease than has been suspected, University of Utah medical researchers show in a new study.
Drug rescues memory lost to Alzheimer's disease
A drug similar to one used in clinical trials for treatment of rheumatoid arthritis and psoriasis has been found to rescue memory in mice exhibiting Alzheimer's symptoms.
Post-transplant combo can replace toxic immune-suppressing drugs in monkeys
Transplant patients rely on drugs to prevent graft rejection, but at the cost of serious side effects.
Psoriasis associated with cardiovascular disease and increased mortality
The skin disease psoriasis is associated with atherosclerosis (a buildup of plaque in the arteries) characterized by an increased prevalence of ischemic heart disease, cerebrovascular disease, peripheral artery disease and an increased risk of death.
Scientists discover new genetic immune disorder in children
Your immune system plays an important function in your health-it protects you against viruses, bacteria, and other toxins that can cause disease.
Study finds unexpected bacterial diversity on human skin
The health of our skin - one of the body's first lines of defense against illness and injury - depends upon the delicate balance between our own cells and the millions of bacteria and other one-celled microbes that live on its surface.
Vitamin D may halt lung function decline in asthma and COPD
Vitamin D may slow the progressive decline in the ability to breathe that can occur in people with asthma as a result of human airway smooth muscle (HASM) proliferation, according to researchers at the University of Pennsylvania.
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