Meta-analysis of psoriasis, cardiovascular disease, and associated risk factors

The possible connection between psoriasis with cardiovascular disease and associated risk factors has been implied, but inconsistent results have been reported.

We sought to create an overview and statistical summary of the previous literature with elucidating subgroup analysis.

This was a meta-analysis of observational studies using random effect statistics. A systematic search of observational studies of psoriasis as study variable and cardiovascular disease and associated risk factors as outcome, published before October 25, 2012, was conducted.

Of 835 references in the original search, 75 relevant articles were identified. We included 503,686 cases and 29,686,694 controls. Psoriasis was associated with cardiovascular disease in total (odds ratio [OR] 1.4; 95% confidence interval [CI] 1.2-1.7), ischemic heart disease (OR 1.5; 95% CI 1.2-1.9), peripheral vascular disease (OR 1.5; 95% CI 1.2-1.8), atherosclerosis (OR 1.1; 95% CI 1.1-1.2), diabetes (OR 1.9; 95% CI 1.5-2.5), hypertension (OR 1.8; 95% CI 1.6-2.0), dyslipidemia (OR 1.5; 95% CI 1.4-1.7), obesity by body mass index (OR 1.8; 95% CI 1.4-2.2), obesity by abdominal fat (OR 1.6; 95% CI 1.2-2.3), and the metabolic syndrome (OR 1.8; 95% CI 1.2-2.8), but not associated with cerebrovascular disease (OR 1.1; 95% CI 0.9-1.3) and cardiovascular mortality (OR 0.9; 95% CI 0.4-2.2). The strongest associations were seen in hospital-based studies and psoriatic arthritis. Population-based studies did not show significant associations, with the exception of dyslipidemia.

The heterogeneity of the studies makes clinical interpretation challenging.

In aggregate, psoriasis was associated with ischemic heart disease and cardiovascular risk factors. The association was only significant for hospital-based studies, except for dyslipidemia, which was also significant in population-based studies.