title: Effect of arterial hypertension on chronic urticaria duration.
abstract: BACKGROUND
  Reliable clinical or laboratory markers of chronic idiopathic urticaria (CIU) duration are not available. Angioedema, autologous serum skin test (ASST) results, and antithyroid antibodies have been inconsistently associated with longer urticaria duration.
  
  
  OBJECTIVE
  To investigate the association of clinical and laboratory parameters with CIU duration, including systemic hypertension, because activation of the coagulation cascade pathway may contribute to the pathogenesis of CIU.
  
  
  METHODS
  We performed a prospective study of a cohort of 228 consecutive adult patients with CIU of moderate to severe intensity referred to 2 outpatient allergy clinics and followed up for a 3- to 5-year period. The association of clinical and laboratory parameters (sex, atopy, markers of autoimmunity, antithyroid antibodies, positive ASST result, Helicobacter pylori infection, and hypertension) with urticaria duration was analyzed using semiparametric multivariable proportional hazards models (Cox regression) using remission as main outcome measure.
  
  
  RESULTS
  Apart from systemic hypertension (hazard ratio, 0.71; 95% confidence interval, 0.53-0.95; P = .02), none of the considered parameters influenced CIU remission of our patients; 74% and 54% of our patients with and without hypertension, respectively, still had CIU after 5 years.
  
  
  CONCLUSIONS
  Our results show, for the first time to our knowledge, that hypertension is associated with extended duration of CIU. This observation, together with the previous findings that point to vascular and coagulation involvement in CIU, may suggest a new approach to antihistamine-refractory CIU treatment, including adequate treatment of hypertension.
authors.affiliation: Allergy and Clinical Immunology, University of Torino and AO Ordine Mauriziano Hospital, Torino, Italy.
authors.forename: Franco
authors.initials: F
authors.lastname: Nebiolo
authors.forename: Roberta
authors.initials: R
authors.lastname: Bergia
authors.forename: Luisa
authors.initials: L
authors.lastname: Bommarito
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Bugiani
authors.forename: Enrico
authors.initials: E
authors.lastname: Heffler
authors.forename: Aurelia
authors.initials: A
authors.lastname: Carosso
authors.forename: Gloria
authors.initials: G
authors.lastname: Castiglioni
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Guida
authors.forename: Iuliana
authors.initials: I
authors.lastname: Badiu
authors.forename: Stefano
authors.initials: S
authors.lastname: Pizzimenti
authors.forename: Sabrina
authors.initials: S
authors.lastname: Mietta
authors.forename: Nicoletta
authors.initials: N
authors.lastname: Ferrero
authors.forename: Giovanni
authors.initials: G
authors.lastname: Rolla
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D015331:Cohort Studies; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006633:Histamine Antagonists / Q000627:therapeutic use; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D016896:Treatment Outcome; D014581:Urticaria / Q000150:complications* / Q000188:drug therapy / Q000503:physiopathology*
chemical_list: D006633:Histamine Antagonists