Psoriatic Arthritis and Cardiovascular Risk

Bret S. Stetka, MD; Agnete Malm G. Gulati, MD


July 16, 2014

Editor's Note: While on site at the 2014 European League Against Rheumatism annual congress, held in Paris, France, June 11-14, 2014, Medscape spoke with Agnete Malm G. Gulati, MD, about her study looking at the association between psoriatic arthritis and cardiovascular risk factors.

Medscape: Can you give us some background on your study?

Agnete G. Malm Gulati, MD: The main objective was to see whether patients with psoriatic arthritis (PsA) had more cardiovascular (CV) risk factors and disease than controls. The second objective was to investigate the 10-year risk for a fatal CV event by using the risk algorithm Systematic Coronary Risk Evaluation (SCORE), We wanted to compare this estimated risk in patients with PsA and the control group.

Medscape: What did you find?

Dr. Gulati: Our findings showed that patients with PsA were more often smokers compared with controls. The other traditional CV risk factors included in the SCORE -- age, sex, systolic blood pressure, and cholesterol -- were similar between the 2 groups, so the SCORE level was comparable. But we found that patients with PsA had increased body mass index (BMI), triglyceride level, C-reactive protein level, and elevated diastolic blood pressure, which are well-known CV risk factors. We also found a higher prevalence rate of angina pectoris and hypertension in the PsA group compared with controls.

Medscape: So the clinical implications of your findings are to be more aware of CV risk factors and health when seeing patients with PsA?

Dr. Gulati: Yes. In our study, the population was fairly young -- around 50 years of age -- so that could be why we did not find a higher prevalence of established CV disease except for angina pectoris. It looks like BMI is a important factor that correlates with high triglyceride levels and hypertension. To modify all of these risks is, of course, important in the general population, but especially in patients with inflammatory joint diseases, including PsA.

Medscape: What do prior findings show about the relationship between PsA and CV risk?

Dr. Gulati: There's a very well-established relationship between rheumatoid arthritis and CV disease, and we're starting to see the same thing in PsA. Although we did not find a higher prevalence of myocardial infarction, stroke, or diabetes in our material studies by other have shown a higher risk for these CV diseases and risk factors in PsA patients.

Medscape: On the basis of your findings, what is your message to clinicians managing patients with PsA?

Dr. Gulati: That it's very important both for patients with PsA and the doctors treating them to be aware of the potential increased CV risk associated with their disease.


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