Cardiovascular comorbidities in patients with a severe form of psoriasis: A case-controlled study assessing clinical, biochemical, and radiological parameters

Abstract

Background: Psoriasis is a common, chronic, inflammatory, and proliferative disorder of the skin, and is associated with elevated lipid levels and exaggerated inflammatory status, which may lead to cardiovascular morbidities and mortalities. Aims: The aim was to estimate the cardiovascular risk profile among psoriatic patients when compared to controls. Settings and Design: This was a case-controlled study performed at a tertiary-care hospital. Methods and Material: One hundred patients with severe psoriasis were evaluated for clinical, biochemical, electrocardiographic, and radiological signs of cardiovascular comorbidities and were compared with one hundred age- and sex-matched controls. Statistical Analysis: IBM Corp. Released 2015. IBM SPSS Statistics for Windows, version 23.0. Armonk, NY: IBM Corp. Results: Males predominated (1.27:1), with the most common age group being 31 to 40 years old. Smoking and alcohol consumption were common among the psoriatic patients (odds ratio = 4.14 and 2.38, respectively). The mean PASI score among the cases was 26.19 ± 10.8, with an extreme effect on their quality of life. The psoriatic patients presented with independent cardiovascular risk factors, including systolic hypertension (148.67 ± 10.91 mm of Hg), elevated fasting blood sugars (129.46 ± 35.64 mg/dL), hypercholesterolemia (152.34 ± 44.56 mg/dL), and hypertriglyceridemia (186.29 ± 29.45 mg/dL), with metabolic syndrome among 41% of the cases. On the electrocardiogram, the P wave was elevated (22%) and the QTc interval was prolonged (20%) among the cases. On high-resolution ultrasonography, the intima–media of the carotid arteries were thickened (0.944 ± 0.132 mm), indicating subclinical atherosclerosis in the psoriatic patients. Conclusions: Early detection and periodic screening for cardiovascular risk factors among psoriatic patients and aggressive therapeutic management are recommended to reduce the disease burden and improve their quality of life.