Meta-analysis of psoriasis, cardiovascular disease, and associated risk factors.
BACKGROUND
The possible connection between psoriasis with cardiovascular disease and associated risk factors has been implied, but inconsistent results have been reported.


OBJECTIVE
We sought to create an overview and statistical summary of the previous literature with elucidating subgroup analysis.


METHODS
This was a meta-analysis of observational studies using random effect statistics. A systematic search of observational studies of psoriasis as study variable and cardiovascular disease and associated risk factors as outcome, published before October 25, 2012, was conducted.


RESULTS
Of 835 references in the original search, 75 relevant articles were identified. We included 503,686 cases and 29,686,694 controls. Psoriasis was associated with cardiovascular disease in total (odds ratio [OR] 1.4; 95% confidence interval [CI] 1.2-1.7), ischemic heart disease (OR 1.5; 95% CI 1.2-1.9), peripheral vascular disease (OR 1.5; 95% CI 1.2-1.8), atherosclerosis (OR 1.1; 95% CI 1.1-1.2), diabetes (OR 1.9; 95% CI 1.5-2.5), hypertension (OR 1.8; 95% CI 1.6-2.0), dyslipidemia (OR 1.5; 95% CI 1.4-1.7), obesity by body mass index (OR 1.8; 95% CI 1.4-2.2), obesity by abdominal fat (OR 1.6; 95% CI 1.2-2.3), and the metabolic syndrome (OR 1.8; 95% CI 1.2-2.8), but not associated with cerebrovascular disease (OR 1.1; 95% CI 0.9-1.3) and cardiovascular mortality (OR 0.9; 95% CI 0.4-2.2). The strongest associations were seen in hospital-based studies and psoriatic arthritis. Population-based studies did not show significant associations, with the exception of dyslipidemia.


CONCLUSIONS
The heterogeneity of the studies makes clinical interpretation challenging.


CONCLUSIONS
In aggregate, psoriasis was associated with ischemic heart disease and cardiovascular risk factors. The association was only significant for hospital-based studies, except for dyslipidemia, which was also significant in population-based studies.
Department of Dermatology, Roskilde Hospital, Roskilde, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark. Electronic address: miller@dadlnet.dk.
Iben Marie
IM
Miller
Christina
C
Ellervik
Shiva
S
Yazdanyar
Gregor B E
GB
Jemec
D002318:Cardiovascular Diseases / Q000150:complications* / Q000453:epidemiology; D006801:Humans; D064887:Observational Studies as Topic; D011565:Psoriasis / Q000150:complications* / Q000453:epidemiology; D012307:Risk Factors
cardiovascular disease; diabetes mellitus; hypercholesterolemia; hypertension; inflammation; meta-analysis; obesity; plaque; psoriasis