title: Psoriasis is not associated with atherosclerosis and incident cardiovascular events: the Rotterdam Study.
abstract: Psoriasis has been suggested to be an independent risk factor for cardiovascular disease (CVD); however, available studies have shown inconsistent results. In this study, embedded within the population-based Rotterdam Study, we aimed to assess the association between psoriasis and cardiovascular outcomes. Adjusted means were calculated for subclinical atherosclerosis using general linear models. Using Cox regression, the hazards of cardiovascular events for psoriasis, as a time-dependent variable, were calculated. A total of 262 psoriasis (24% systemic/UV treatment) and 8,009 reference subjects were followed up for a mean of 11 years. Psoriasis patients were significantly younger, smoked more, and had higher diastolic blood pressure and body mass index levels. The adjusted carotid intima-media thickness was 1.02±0.18 mm for psoriasis and 1.02±0.16 mm for reference subjects. Similarly, crude and adjusted ankle-brachial index, pulse-wave velocity, and coronary artery calcium scores did not differ between the two groups. The risk of incident CVD was not increased in psoriasis (adjusted hazard ratio 0.73, 95% confidence interval 0.50-1.06). The results were similar when coronary heart disease, stroke, and heart failure were analyzed separately. Psoriasis patients with predominantly mild disease from the general population are as likely to develop atherosclerosis and cardiovascular events as subjects without psoriasis.
authors.affiliation: Department of Dermatology, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: Emmilia A
authors.initials: EA
authors.lastname: Dowlatshahi
authors.affiliation: Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: Maryam
authors.initials: M
authors.lastname: Kavousi
authors.affiliation: Department of Dermatology, Erasmus University Medical Center, Rotterdam, The Netherlands. Electronic address: t.nijsten@erasmusmc.nl.
authors.forename: Tamar
authors.initials: T
authors.lastname: Nijsten
authors.affiliation: Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands; Department of Radiology, Erasmus University Medical Center, Rotterdam, The Netherlands; Department of Neurology, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: M Arfan
authors.initials: MA
authors.lastname: Ikram
authors.affiliation: Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: Albert
authors.initials: A
authors.lastname: Hofman
authors.affiliation: Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: Oscar H
authors.initials: OH
authors.lastname: Franco
authors.affiliation: Department of Dermatology, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: Marlies
authors.initials: M
authors.lastname: Wakkee
mesh_terms: D000368:Aged; D002340:Carotid Artery Diseases / Q000453:epidemiology*; D003324:Coronary Artery Disease / Q000453:epidemiology*; D005260:Female; D006333:Heart Failure / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology*; D009426:Netherlands / Q000453:epidemiology; D016016:Proportional Hazards Models; D011565:Psoriasis / Q000453:epidemiology*; D012307:Risk Factors