Psoriasis and Hypertension Severity: Results from a Case-Control Study

BACKGROUND: Epidemiologic studies have provided new insights into the association between psoriasis and cardiovascular diseases. Previous population studies have examined hypertension frequency in psoriasis patients. However, the relationship between severity of hypertension and psoriasis has not been characterized. OBJECTIVE: We sought to investigate whether patients with psoriasis have more difficult-to-manage hypertension compared to non-psoriatic hypertensive patients. APPROACH: We performed a case-control study using the University of California Davis electronic medical records. The cases were defined as patients diagnosed with both psoriasis and hypertension, and controls were defined as patients with hypertension and without psoriasis. In this identified population, 835 cases were matched on age, sex, and body mass index (BMI) to 2418 control patients. KEY RESULTS: Treatment with multiple anti-hypertensives was significantly associated with the presence of psoriasis using univariate (p < 0.0001) and multivariable analysis, after adjusting for diabetes, hyperlipidemia, and race (p < 0.0001). Compared to hypertensive patients without psoriasis, psoriasis patients with hypertension were 5 times more likely to be on a monotherapy antihypertensive regimen (95% CI 3.607.05), 9.5 times more likely to be on dual antihypertensive therapy (95% CI 6.68-13.65), 16.5 times more likely to be on triple antihypertensive regimen (95% CI 11.01-24.84), and 19.9 times more likely to be on quadruple therapy or centrally-acting agent (95% CI 10.58-37.33) in multivariable analysis after adjusting for traditional cardiac risk factors. CONCLUSIONS: Psoriasis patients appear to have more difficult-to-control hypertension compared to non-psoriatic, hypertensive patients

Univariate analysis examining relationship between hypertension severity and presence of psoriasis.

<p>Univariate analysis examining relationship between hypertension severity and presence of psoriasis.</p

Demographic and clinical characteristics of patients with psoriasis and hypertension (cases) and those with hypertension without psoriasis (controls).

<p>Percentages are followed by number of cases (in parentheses). For race, smoking status, and alcohol use, the analysis includes only patients with complete data on these parameters.</p>†<p>Chi-square test was used to determine significance.</p>‡<p>Fisher's exact test was used to determine significance.</p><p>*Student's t-test was used to determine significance.</p

Multivariate analysis examining relationship between hypertension severity and presence of psoriasis adjusting for diabetes mellitus, smoking, hyperlipidemia, and race.

<p>Controls are age, sex, and BMI–matched.</p