Psoriatic arthritis is associated with higher rates of self-reported angina pectoris, percutaneous coronary intervention, hypertension, obesity, and smoking than are observed in the general population, a large population-based cohort study found.
However, the overall rate of cardiovascular (CV) disease (defined as one or more of angina pectoris, myocardial infarction, cerebrovascular stroke, coronary artery bypass graft, or percutaneous coronary intervention) was 8% in both the 338 patients with psoriatic arthritis (PsA) and the 50,468 controls in the Nord-Trøndelag Health Study. A similar percentage of patients with PsA (13.4%) and controls (11.3%) were deemed to be at very high 10-year risk for a fatal cardiovascular event based on the Systematic Coronary Risk Evaluation (SCORE) algorithm, and the median risk calculated by the algorithm was similar for both groups, Dr. Agnete Malm Gulati of St. Olavs Hospital, Trondheim, Norway, and her coauthors reported. But patients with PsA had significantly higher C-reactive protein levels, body mass index, and diastolic blood pressure, which are not included in the SCORE algorithm.
Patients with PsA had lived with the disease for a mean of 9.3 years, and both patients and controls had a mean age of about 54 years.
The study’s authors said their findings supported previous suggestions that the increased risk of CV disease in psoriatic arthritis was largely a reflection of an increased prevalence of conventional risk factors such as obesity, smoking, and hypertension (Ann. Rheum. Dis. 2015 March 26 [doi:10.1136/annrheumdis-2014-206824]).
“In RA [rheumatoid arthritis], it is shown that atherosclerosis cannot solely be explained by the presence of traditional CV risk factors, and chronic inflammation has also been proposed as being responsible for the enhanced development of atherosclerosis in these patients, [and] this may also be the case for patients with PsA,” the investigators wrote.
The study was supported by Revmafondet i Trondheim, and one author reported financial support from Pfizer. There were no other conflicts of interest declared.