Young African American patients with psoriasis are at a higher risk of atherosclerotic cardiovascular disease (ASCVD) and traditional cardiovascular risk factors than white patients with psoriasis of the same age group, according to a research letter published online February 20, 2019 in JAMA Dermatology.1
Researchers at the University of Chicago and Northwestern University hospitals used International Classification of Diseases, Ninth Revision (ICD-9) or Tenth Revision (ICD-10) codes and demographics to query the i2b2 platform (i2b2 tranSMART Foundation) for aggregated electronic medical record patient data spanning 2008 to 2018. Included in their analysis were the medical records of 1,991,149 adults. More than 500K of the patients were African American and more than one million were white patients. Of this group, 12,184 had a diagnosis of psoriasis, according to the research letter.
The authors found that most cardiovascular risk factors were more prevalent among patients of both races who had psoriasis. The prevalence of ASCVD was 2.4 fold higher among patients with psoriasis compared with those who did not have psoriasis. In bivariate analysis, patients with psoriasis and diabetes or hypertension had higher rates of ASCVD compared with patients with diabetes or hypertension who did not have psoriasis.
However, traditional cardiovascular risk factor burden was higher in African American patients aged 18-44 years with psoriasis than in white patients in this age group and the African American patients with psoriasis had a 3.1-fold increase in ASCVD compared with white patients.
The authors noted that while the association between psoriasis and ASCVD is complex and the study had some limitations, the sample was sufficiently large and diverse enough to reveal insights, and the finding could inform decisions to refer some patients for early cardiovascular risk assessment and reduction.
“Our study offers a nuanced view of this association within the context of age, race, and sex. Particular subgroups of patients with psoriasis are at greater risk of ASCVD than other groups,” the authors wrote.
1. Arnold KA, Treister AD, Lio PA, Alenghat FJ. Association of Atherosclerosis Prevalence With Age, Race, and Traditional Risk Factors in Patients With Psoriasis. JAMA Dermatol. 2019;155(5):622–623. doi:10.1001/jamadermatol.2018.5462