Uncontrolled Hypertension Highest Among Patients with Moderate/Severe Psoriasis

Bottom Line: Patients with moderate and severe psoriasis have the greatest likelihood of uncontrolled hypertension compared to patients without psoriasis.

Author: Junko Takeshita, M.D., Ph.D., of the University of Pennsylvania Perelman School of Medicine, Philadelphia, and colleagues.

Background: Psoriasis is a chronic inflammatory disease of the skin and cardiovascular risk factors, including hypertension, are more prevalent among patients with psoriasis compared to those patients without. Previous studies suggest that psoriasis, especially when it is more severe, is associated with an increased risk of cardiovascular events such as heart attack, stroke and death.

How the Study Was Conducted: The authors examined the effect of psoriasis and its severity (which was measured by affected body surface area) on blood pressure control among patients with hypertension. The study included 1,322 patients with psoriasis and hypertension and 11,977 controls with hypertension but without psoriasis.

Results: The authors discovered a “dose-response relationship” between uncontrolled hypertension and psoriasis severity, which means the likelihood of uncontrolled hypertension increased with severity of the skin condition. Hence, the likelihood of uncontrolled hypertension was greatest among patients with moderate and severe psoriasis. Patients with psoriasis were equally as likely to be receiving antihypertensive treatment as were patients without psoriasis. The likelihood of treatment did not differ by the severity of the psoriasis.

Discussion: “Adding to the currently limited understanding of the effects of comorbid disease on hypertension, our findings have important clinical implications, suggesting a need for more effective management of blood pressure in patients with psoriasis, especially those with more extensive skin involvement [greater than or equal to 3 percent of body surface area affected].”

(JAMA Dermatology. Published online October 15, 2014. doi:10.1001/jamadermatol.2014.2094.