Psoriasis and risk of nonfatal cardiovascular disease in U.S. women: A cohort study

W. Q. Li, Jiali Han, J. E. Manson, E. B. Rimm, K. M. Rexrode, G. C. Curhan, A. A. Qureshi

Research output: Contribution to journalArticle

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Abstract

Background Psoriasis has been linked to cardiovascular comorbidities in cross-sectional studies, but evidence regarding the association between psoriasis and incident cardiovascular disease (CVD) is limited. Objectives To make a prospective evaluation of the association between psoriasis and risk of incident nonfatal CVD. Methods Participants (n = 96 008) were included from the Nurses' Health Study II, and followed for 18 years. Information on physician-diagnosed psoriasis was obtained by self-report and diagnosis was confirmed by supplementary questionnaires. We included 2463 individuals with self-reported psoriasis and a subsample of 1242 with validated psoriasis. The main outcome was incident nonfatal CVD events [nonfatal myocardial infarction (MI) and nonfatal stroke], ascertained by biennial questionnaires and confirmed. Results During 1 709 069 person-years of follow-up, 713 incident nonfatal CVD events were confirmed. Psoriasis was associated with a significantly increased multivariate-adjusted hazard ratio (HR) of nonfatal CVD, 1·55 [95% confidence interval (CI): 1·04-2·31]. HRs for nonfatal MI and stroke were 1·70 (95% CI: 1·01-2·84) and 1·45 (95% CI: 0·80-2·65), respectively. The association remained consistent in a sensitivity analysis of confirmed psoriasis (HR: 2·06, 95% CI: 1·31-3·26). For individuals with concomitant psoriatic arthritis, the risk of nonfatal CVD was even higher (HR: 3·47; 95% CI: 1·85-6·51). Women diagnosed with psoriasis at < 40 years of age or with duration of psoriasis ≥ 9 years had substantial elevations in CVD risk: HR: 3·26 (95% CI: 1·21-8·75) and 3·09 (95% CI: 1·15-8·29), respectively. Conclusions Psoriasis is an independent predictor for nonfatal CVD among women, with particularly high risk for those with longer duration of psoriasis and concomitant psoriatic arthritis.

Original languageEnglish (US)
Pages (from-to)811-818
Number of pages8
JournalBritish Journal of Dermatology
Volume166
Issue number4
DOIs
StatePublished - Apr 1 2012
Externally publishedYes

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Psoriasis
Cohort Studies
Cardiovascular Diseases
Confidence Intervals
Psoriatic Arthritis
Stroke
Myocardial Infarction
Self Report
Comorbidity
Cross-Sectional Studies
Odds Ratio
Nurses
Physicians

ASJC Scopus subject areas

  • Dermatology

Cite this

Li, W. Q., Han, J., Manson, J. E., Rimm, E. B., Rexrode, K. M., Curhan, G. C., & Qureshi, A. A. (2012). Psoriasis and risk of nonfatal cardiovascular disease in U.S. women: A cohort study. British Journal of Dermatology, 166(4), 811-818. https://doi.org/10.1111/j.1365-2133.2011.10774.x

Psoriasis and risk of nonfatal cardiovascular disease in U.S. women : A cohort study. / Li, W. Q.; Han, Jiali; Manson, J. E.; Rimm, E. B.; Rexrode, K. M.; Curhan, G. C.; Qureshi, A. A.

In: British Journal of Dermatology, Vol. 166, No. 4, 01.04.2012, p. 811-818.

Research output: Contribution to journalArticle

Li, W. Q. ; Han, Jiali ; Manson, J. E. ; Rimm, E. B. ; Rexrode, K. M. ; Curhan, G. C. ; Qureshi, A. A. / Psoriasis and risk of nonfatal cardiovascular disease in U.S. women : A cohort study. In: British Journal of Dermatology. 2012 ; Vol. 166, No. 4. pp. 811-818.
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abstract = "Background Psoriasis has been linked to cardiovascular comorbidities in cross-sectional studies, but evidence regarding the association between psoriasis and incident cardiovascular disease (CVD) is limited. Objectives To make a prospective evaluation of the association between psoriasis and risk of incident nonfatal CVD. Methods Participants (n = 96 008) were included from the Nurses' Health Study II, and followed for 18 years. Information on physician-diagnosed psoriasis was obtained by self-report and diagnosis was confirmed by supplementary questionnaires. We included 2463 individuals with self-reported psoriasis and a subsample of 1242 with validated psoriasis. The main outcome was incident nonfatal CVD events [nonfatal myocardial infarction (MI) and nonfatal stroke], ascertained by biennial questionnaires and confirmed. Results During 1 709 069 person-years of follow-up, 713 incident nonfatal CVD events were confirmed. Psoriasis was associated with a significantly increased multivariate-adjusted hazard ratio (HR) of nonfatal CVD, 1·55 [95{\%} confidence interval (CI): 1·04-2·31]. HRs for nonfatal MI and stroke were 1·70 (95{\%} CI: 1·01-2·84) and 1·45 (95{\%} CI: 0·80-2·65), respectively. The association remained consistent in a sensitivity analysis of confirmed psoriasis (HR: 2·06, 95{\%} CI: 1·31-3·26). For individuals with concomitant psoriatic arthritis, the risk of nonfatal CVD was even higher (HR: 3·47; 95{\%} CI: 1·85-6·51). Women diagnosed with psoriasis at < 40 years of age or with duration of psoriasis ≥ 9 years had substantial elevations in CVD risk: HR: 3·26 (95{\%} CI: 1·21-8·75) and 3·09 (95{\%} CI: 1·15-8·29), respectively. Conclusions Psoriasis is an independent predictor for nonfatal CVD among women, with particularly high risk for those with longer duration of psoriasis and concomitant psoriatic arthritis.",
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AU - Li, W. Q.

AU - Han, Jiali

AU - Manson, J. E.

AU - Rimm, E. B.

AU - Rexrode, K. M.

AU - Curhan, G. C.

AU - Qureshi, A. A.

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AB - Background Psoriasis has been linked to cardiovascular comorbidities in cross-sectional studies, but evidence regarding the association between psoriasis and incident cardiovascular disease (CVD) is limited. Objectives To make a prospective evaluation of the association between psoriasis and risk of incident nonfatal CVD. Methods Participants (n = 96 008) were included from the Nurses' Health Study II, and followed for 18 years. Information on physician-diagnosed psoriasis was obtained by self-report and diagnosis was confirmed by supplementary questionnaires. We included 2463 individuals with self-reported psoriasis and a subsample of 1242 with validated psoriasis. The main outcome was incident nonfatal CVD events [nonfatal myocardial infarction (MI) and nonfatal stroke], ascertained by biennial questionnaires and confirmed. Results During 1 709 069 person-years of follow-up, 713 incident nonfatal CVD events were confirmed. Psoriasis was associated with a significantly increased multivariate-adjusted hazard ratio (HR) of nonfatal CVD, 1·55 [95% confidence interval (CI): 1·04-2·31]. HRs for nonfatal MI and stroke were 1·70 (95% CI: 1·01-2·84) and 1·45 (95% CI: 0·80-2·65), respectively. The association remained consistent in a sensitivity analysis of confirmed psoriasis (HR: 2·06, 95% CI: 1·31-3·26). For individuals with concomitant psoriatic arthritis, the risk of nonfatal CVD was even higher (HR: 3·47; 95% CI: 1·85-6·51). Women diagnosed with psoriasis at < 40 years of age or with duration of psoriasis ≥ 9 years had substantial elevations in CVD risk: HR: 3·26 (95% CI: 1·21-8·75) and 3·09 (95% CI: 1·15-8·29), respectively. Conclusions Psoriasis is an independent predictor for nonfatal CVD among women, with particularly high risk for those with longer duration of psoriasis and concomitant psoriatic arthritis.

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