Evaluation of cardiovascular risk factors among patients with psoriasis, psoriatic arthritis and peripheral spondyloarthritis

Abstract

It is well known that the prevalence of Cardiovascular Risk Factors (CVRF) in patients with Psoriatic Arthritis (PsA) is higher than in the general population. However, there is a lack of studies comparing PsA against Psoriasis without arthritis, and also against peripheral Spondyloarthritis (SpA). The objectives of this study were: a) to compare the prevalence of CVRF among patients with PsA, Psoriasis without arthritis, and peripheral SpA without Psoriasis; and b) to evaluate the association between CVRF and the presence of arthritis and/or Psoriasis. A cross-sectional, observational, and unicenter study was conducted, analyzing clinical, analytical, and demographic data from 300 patients. Patients were divided into four groups: PsA, Psoriasis without arthritis, peripheral SpA without Psoriasis, and controls. Patients with PsA and peripheral SpA met CASPAR and peripheral ASAS criteria, respectively. Hypertension, Diabetes (T2DM), and Dyslipidemia were evaluated among the four groups using the chi-square test. To evaluate whether CVRF could be explained by the presence of arthritis or Psoriasis, patients (excluding control groups) were divided into arthritis/no arthritis and Psoriasis/no Psoriasis groups. Univariate and multivariate logistic regressions adjusted by sex and age were performed to determine variables independently associated with the presence of these three CVRF. Among the 300 patients included, 89 (29.7%), 35 (11.7%), and 87 (29%) patients reported Hypertension, T2DM, and Dyslipidemia, respectively. Regarding classification, 61 (20.3%) patients, 100 (33.3%), 100 (33.3%), and 39 (13.0%) patients were classified as control group, Peripheral SpA without Psoriasis, PsA, and Psoriasis without arthritis, respectively. Patients from the control group showed significantly lower prevalence of Hypertension and Dyslipidemia compared to the other three groups (p<0.05); however, there were no differences between the Peripheral SpA group, PsA, and Psoriasis without arthritis regarding CVRF. Patients with arthritis showed similar prevalence of CVRF compared to those without arthritis, as well as patients with Psoriasis vs. no Psoriasis. Univariate analysis showed that Hypertension is significantly associated (p<0.05) with AINEs intake [OR 1.79 (95%CI 1.06–2.99)] and with disease duration [OR 1.02 (95%CI 1.01–1.05)], although the multivariate analysis adjusted by age and sex did not show significant differences. Regarding T2DM and dyslipidemia, the presence of arthritis or Psoriasis was not associated with the development of these comorbidities. Our data suggest that the prevalence of CVRF among patients with Psoriasis, PsA, and peripheral SpA is similar, although it is higher than in the general population. The presence of Hypertension in these patients is associated with the use of NSAIDs; however, larger studies would be necessary to determine specific associations.