Hidradenitis Suppurativa: Beyond Skin Concerns to Focus on Cardiovascular Considerations

Hidradenitis suppurativa (HS) is a poorly recognized chronic skin condition that presents with inflamed recurring painful nodules, abscesses, and subcutaneous tunnels, mainly impacting intertriginous areas. Although extensively studied for its dermatological implications, recent research suggests a potential correlation between HS and cardiovascular disease. Studies reveal a heightened prevalence of cardiovascular risk factors, such as obesity, metabolic syndrome, and smoking, in individuals with HS. Most researchers attribute HS's elevated cardiovascular risk to these coexisting factors.

This review aims to identify whether or not HS's underlying chronic inflammatory nature can contribute to atherosclerosis development, thereby elevating the risk of cardiovascular events and, specifically, major adverse cardiovascular events (MACE). Recognizing the association between HS and cardiovascular disease is crucial for comprehensive patient care.

A PubMed search was performed to locate clinical trials, systematic reviews, and clinical reviews published to date concerning this topic.

This review consolidates existing literature on the topic, summarizing key findings and emphasizing the need for further research to clarify the mechanisms linking HS and cardiovascular conditions and delineating best clinical practices to mitigate risk.

Many publications attribute the increase in cardiovascular disease to comorbid risk factors. Despite limited research on cardiovascular (CV) risk in patients with HS, emerging evidence indicates an increased risk of adverse CV outcomes in this population, consistent with data from other chronic inflammatory diseases indicating that the inflammatory nature of the disease itself is elevating cardiovascular events. More clinical research is needed to strengthen this hypothesis and improve patient outcomes.

An integrated, multidisciplinary approach combining dermatological and cardiovascular perspectives is vital for optimizing patient care and navigating the complexities of managing HS and its associated cardiovascular comorbidities.