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Cardiovascular comorbidities in psoriatic arthritis: epidemiology and risk factors in two different European
Silvia Scriffignano1, Rik Lories2, Adrien Nzeusseu Toukap3
1Department of Rheumatology, UZ Leuven; Department Development and Regeneration, Skeletal Biology and Engineering Research Center KU Leuven, Belgium, and Dipartimento di Medicina di Precisione, Section of Reumatology, Università degli Studi della Campania L. Vanvitelli, Naples, Italy.
Insights
Italian patients with psoriatic arthritis (PsA) have higher rates of cardiovascular comorbidities, including arterial hypertension (AH) and type 2 diabetes (T2D), compared to Belgian patients. These findings highlight potential geographic or sociocultural factors influencing cardiovascular risk in PsA.
Area of Science:
- Rheumatology
- Cardiology
- Epidemiology
Background:
- Psoriatic arthritis (PsA) is a chronic inflammatory condition often linked with cardiovascular (CV) comorbidities.
- Understanding geographic variations in CV risk factors among PsA patients is crucial for targeted prevention strategies.
Purpose of the Study:
- To compare the prevalence of cardiovascular comorbidities in psoriatic arthritis patients from Belgium and Italy.
- To identify potential differences in CV risk profiles between these two European cohorts.
Main Methods:
- A cross-sectional analysis of 803 psoriatic arthritis patients (463 from Belgium, 340 from Italy) meeting CASPAR criteria.
- Data collected included demographics, clinical assessments, smoking habits, arterial hypertension (AH), obesity, type 2 diabetes (T2D), and cardiovascular diseases.
- Dyslipidemia and hypercholesterolemia data were collected based on country-specific criteria.
Main Results:
- Italian PsA patients exhibited higher prevalence of AH (45.1% vs. 26.4%), T2D (14.2% vs. 7.6%), and CV diseases (7.1% vs. 3.5%) compared to Belgian patients.
- After adjusting for confounders, Italian patients had a significantly higher risk of hypertension (OR 2.00, p=0.007).
- Obesity prevalence was similar, and lipid profiles were unfavorable in both groups, though not directly comparable.
Conclusions:
- The prevalence of AH, T2D, and CV diseases is significantly higher in Italian PsA patients than in Belgian PsA patients.
- The risk of AH is notably elevated in the Italian cohort, suggesting the influence of factors beyond traditional CV risk factors.
- Further research into extrinsic factors like geography and sociocultural aspects is warranted to understand and mitigate CV risk in PsA.
Objectives:
Psoriatic arthritis (PsA) is a chronic inflammatory disease, frequently associated with cardiovascular (CV) comorbidities. Our aim was to compare the prevalence of CV comorbidities between two groups of PsA patients from different European countries: Belgium and Italy.
Methods:
This is a cross-sectional analysis of two longitudinal cohorts in which 803 PsA patients were enrolled (463 from Belgium and 340 from Italy). All enrolled patients were ≥18 years old and fulfilled the ClASsification criteria for Psoriatic Arthritis (CASPAR criteria). For each patient, demographics, clinical assessments, smoking habits, the presence of arterial hypertension (AH), obesity (BMI ≥30), type 2 diabetes (T2D), CV diseases (acute myocardial infarction, stroke or transient ischaemic attack), dyslipidaemia (Italy only) and hypercholesterolaemia (Belgium only) were collected.
Results:
The most prevalent comorbidities among Italian patients with PsA were: AH (45.1%), dyslipidaemia (38.6%) and obesity (30.8%), and among Belgian patients were: hypercholesterolaemia (30.9%), obesity (27%) and AH (26.4%). Moreover, the prevalence of T2D and CV diseases was respectively 14.2% and 7.1% among Italian patients and 7.6% and 3.5% among Belgian patients. When comparing the two groups, AH, T2D and CV diseases were significantly more prevalent in Italian PsA patients. After controlling for different confounders, Italian patients, regardless of age, sex, smoking habits, PsA duration, other CV comorbidities, therapy, disease activity and function, had a higher risk to be hypertensive (OR 2.00, p=0.007). Instead of the country in which patients lived was not a predictor for the risk of T2D and CV diseases. Obesity prevalence was not different between the two groups. The lipid profile was unfavourable in both populations (even if not comparable between the two groups, due to the different way of collection), as is often the case in PsA.
Conclusions:
The prevalence of AH, T2D and CV diseases were higher in Italian patients rather than Belgians. Moreover, among patients with PsA, the risk of AH was higher in the Italian cohort compared to the Belgian cohort. These results suggest that further research is needed to evaluate potential extrinsic factors (geography and sociocultural aspects) that may contribute to CV risk.
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