Patel RV, Shelling ML, Prodanovich S, Federman DG, Kirsner RS, et al.
Journal of general internal medicine. Date of publication 2011 Sep 1;volume 26(9):1036-49.
1. J Gen Intern Med. 2011 Sep;26(9):1036-49. doi: 10.1007/s11606-011-1698-5. Epub
2011 Apr 7.
Psoriasis and vascular disease-risk factors and outcomes: a systematic review of
the literature.
Patel RV(1), Shelling ML, Prodanovich S, Federman DG, Kirsner RS.
Author information:
(1)Department of Dermatology and Cutaneous Surgery, University of Miami Miller
School of Medicine, 1600 N.W. 10th Avenue, Miami, FL 33136, USA.
BACKGROUND: Psoriasis afflicts 2-3% of the world's population. Affected patients
commonly have risk factors for cardiovascular disease (CVD). In addition,
psoriasis is independently associated with CVD and mortality.
PURPOSE: To determine which CVD risk factors are associated with psoriasis
independent of confounders, whether psoriasis is associated with CVD independent
of CVD risk factors, and whether there is increased mortality among patients with
psoriasis.
DATA SOURCES: MEDLINE, Embase, and Cochrane Collaborations from inception through
October 2009. We reviewed bibliographies of retrieved articles for additional
references.
STUDY SELECTION: Cross-sectional, cohort-based, case-control, and randomized
controlled trials which involved patients with psoriasis.
DATA EXTRACTION: Two investigators independently reviewed studies and resolved
any discrepancies by consensus.
DATA SYNTHESIS: Of the 2,303 articles identified by literature search, 90 studies
met inclusion criteria for this review; 15 were cohort-based studies, 45 were
case-control, and 30 were cross-sectional.
LIMITATIONS: The quality of evidence was limited by study heterogeneity and lack
of large scale prospective studies with long-term follow-up.
CONCLUSIONS: Patients with psoriasis demonstrate a higher prevalence of
cardiovascular risk factors and appear to be at increased risk for ischemic heart
disease, cerebrovascular disease, and peripheral arterial disease. This increase
in vascular disease may be independent of shared risk factors and may contribute
to the increase in all-cause mortality. Future research should aim to more
confidently distinguish between a true causal relationship or merely an
association resulting from multiple shared risk factors. Physicians should screen
for and aggressively treat modifiable risk factors for CVD in patients with
psoriasis.
DOI: 10.1007/s11606-011-1698-5
PMCID: PMC3157521
PMID: 21472501 [Indexed for MEDLINE]
