title: Primary care-based screening for cardiovascular risk factors in patients with psoriasis.
abstract: BACKGROUND
  Studies assessing cardiovascular disease (CVD) risk factors in patients with psoriasis have been limited by selection bias, inappropriate controls or a reliance on data collected for clinical reasons.
  
  
  OBJECTIVE
  To investigate whether screening for CVD risk factors in patients with psoriasis in primary care augments the known prevalence of CVD risk factors in a cross-sectional study.
  
  
  METHODS
  Patients listed as having psoriasis in primary care were recruited, screened and risk assessed by QRISK2.
  
  
  RESULTS
  In total, 287 patients attended (mean age 53 years, 57% women, 94% white British, 22% severe disease, 33% self-reported psoriatic arthritis). The proportion with known and screen-detected (previously unknown) risk factors was as follows: hypertension 35% known and 13% screen-detected; hypercholesterolaemia 32% and 37%; diabetes 6·6% and 3·1% and chronic kidney disease 1·1% and 4·5%. At least one screen-detected risk factor was found in 48% and two or more risk factors were found in 21% of patients. One in three patients (37%) not previously known to be at high risk were found to have a high (> 10%) 10-year CVD risk. Among the participants receiving treatment for known CVD risk factors, nearly half had suboptimal levels for blood pressure (46%) and cholesterol (46%).
  
  
  CONCLUSIONS
  Cardiovascular risk factor screening of primary care-based adults with psoriasis identified a high proportion of patients (i) at high CVD risk, (ii) with screen-detected risk factors and (iii) with suboptimally managed known risk factors. These findings need to be considered alongside reports that detected limited responses of clinicians to identified risk factors before universal CVD screening can be recommended.
authors.affiliation: The Endocrinology and Diabetes Research Group, Institute of Human Development, Faculty of Medical and Human Sciences, University of Manchester, Manchester Academic Health Science Centre, Manchester, U.K.|Manchester Diabetes Centre, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, U.K.
authors.forename: M K
authors.initials: MK
authors.lastname: Rutter
authors.affiliation: Centre for Dermatology Research, Institute of Inflammation and Repair, University of Manchester, Manchester Academic Health Science Centre, Manchester, U.K.
authors.forename: K
authors.initials: K
authors.lastname: Kane
authors.affiliation: Arthritis Research U.K. Centre for Epidemiology, Centre for Musculoskeletal Research, Institute of Inflammation and Repair, University of Manchester, Manchester Academic Health Science Centre, Manchester, U.K.|NIHR Manchester Musculoskeletal Biomedical Research Unit, Manchester, U.K.
authors.forename: M
authors.initials: M
authors.lastname: Lunt
authors.affiliation: Centre for Dermatology Research, Institute of Inflammation and Repair, University of Manchester, Manchester Academic Health Science Centre, Manchester, U.K.|Manchester Centre for Health Psychology, School of Psychological Sciences, University of Manchester, Manchester Academic Health Science Centre, Manchester, U.K.
authors.forename: L
authors.initials: L
authors.lastname: Cordingley
authors.affiliation: Centre for Dermatology Research, Institute of Inflammation and Repair, University of Manchester, Manchester Academic Health Science Centre, Manchester, U.K.
authors.forename: A
authors.initials: A
authors.lastname: Littlewood
authors.affiliation: Centre for Dermatology Research, Institute of Inflammation and Repair, University of Manchester, Manchester Academic Health Science Centre, Manchester, U.K.|Centre for Dermatology Research, Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, U.K.
authors.forename: H S
authors.initials: HS
authors.lastname: Young
authors.affiliation: Research Institute, Primary Care and Health Sciences, Keele University, Keele, U.K.|South Staffordshire and Shropshire Healthcare NHS Foundation Trust, Stafford, U.K.
authors.forename: C A
authors.initials: CA
authors.lastname: Chew-Graham
authors.affiliation: Bridgewater Community Healthcare NHS Trust, Wigan, U.K.
authors.forename: R
authors.initials: R
authors.lastname: Hilton
authors.affiliation: Arthritis Research U.K. Centre for Epidemiology, Centre for Musculoskeletal Research, Institute of Inflammation and Repair, University of Manchester, Manchester Academic Health Science Centre, Manchester, U.K.|NIHR Manchester Musculoskeletal Biomedical Research Unit, Manchester, U.K.
authors.forename: D P M
authors.initials: DP
authors.lastname: Symmons
authors.affiliation: Centre for Dermatology Research, Institute of Inflammation and Repair, University of Manchester, Manchester Academic Health Science Centre, Manchester, U.K.|Centre for Dermatology Research, Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, U.K.
authors.forename: C E M
authors.initials: CE
authors.lastname: Griffiths
mesh_terms: D015535:Arthritis, Psoriatic / Q000150:complications; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D003430:Cross-Sectional Studies; D048909:Diabetes Complications / Q000150:complications; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D006937:Hypercholesterolemia / Q000150:complications; D006973:Hypertension / Q000150:complications; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011565:Psoriasis / Q000150:complications*; D051436:Renal Insufficiency, Chronic / Q000150:complications; D012307:Risk Factors; D057566:Self Report