Psoriasis and Hypertension Severity: Results from a Case-Control Study
Psoriasis and Hypertension Severity: Results from a Case-Control Study
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DOI：
10.1371/journal.pone.0018227
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发表时间：
2011-03-29
期刊：
影响因子：
3.7
通讯作者：
Chin, David L.
中科院分区：
文献类型：
--
作者：
Armstrong, April W.;Lin, Steven W.;Chin, David L.
背景：流行病学研究为银屑病与心血管疾病之间的关系提供了新的见解。以前的人群研究已经检查了牛皮癣患者的高血压频率。然而，高血压严重程度与牛皮癣之间的关系尚未明确。目的：我们试图调查银屑病患者是否比非银屑病高血压患者有更多难以控制的高血压。方法：我们使用加州大学戴维斯分校的电子医疗记录进行病例对照研究。病例定义为诊断为牛皮癣和高血压的患者，对照组定义为高血压但无牛皮癣的患者。在这个确定的人群中，835例在年龄、性别和体重指数（BMI）上与2418例对照患者相匹配。关键结果：在调整糖尿病、高脂血症和种族（p < 0.0001）后，单因素分析（p < 0.0001）和多变量分析（p < 0.0001）显示，多种抗高血压药物治疗与牛皮癣的存在显著相关。与无银屑病的高血压患者相比，银屑病合并高血压患者接受单药降压方案的可能性高5倍（95% CI 3.607.05），接受双药降压方案的可能性高9.5倍（95% CI 6.68-13.65），接受三联降压方案的可能性高16.5倍（95% CI 11.01-24.84）。在调整传统心脏危险因素后的多变量分析中，接受四联疗法或中央作用药物的可能性高出19.9倍（95% CI 10.58-37.33）。结论：与非银屑病高血压患者相比，银屑病患者出现更多难以控制的高血压。
Background: Epidemiologic studies have provided new insights into the association between psoriasis and cardiovascular diseases. Previous population studies have examined hypertension frequency in psoriasis patients. However, the relationship between severity of hypertension and psoriasis has not been characterized.Objective: We sought to investigate whether patients with psoriasis have more difficult-to-manage hypertension compared to non-psoriatic hypertensive patients.Approach: We performed a case-control study using the University of California Davis electronic medical records. The cases were defined as patients diagnosed with both psoriasis and hypertension, and controls were defined as patients with hypertension and without psoriasis. In this identified population, 835 cases were matched on age, sex, and body mass index (BMI) to 2418 control patients.Key Results: Treatment with multiple anti-hypertensives was significantly associated with the presence of psoriasis using univariate (p < 0.0001) and multivariable analysis, after adjusting for diabetes, hyperlipidemia, and race (p < 0.0001). Compared to hypertensive patients without psoriasis, psoriasis patients with hypertension were 5 times more likely to be on a monotherapy antihypertensive regimen (95% CI 3.607.05), 9.5 times more likely to be on dual antihypertensive therapy (95% CI 6.68-13.65), 16.5 times more likely to be on triple antihypertensive regimen (95% CI 11.01-24.84), and 19.9 times more likely to be on quadruple therapy or centrally-acting agent (95% CI 10.58-37.33) in multivariable analysis after adjusting for traditional cardiac risk factors.Conclusions: Psoriasis patients appear to have more difficult-to-control hypertension compared to non-psoriatic, hypertensive patients.