Cardiovascular and cerebrovascular morbidity increased in psoriatic arthritis

[Fred]

This study looked at the risk of cardiovascular and cerebrovascular morbidity in patients with psoriatic arthritis and it doesn't make good reading.

Quote:

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Objective:
To assess the magnitude of risk of cardiovascular and cerebrovascular morbidity in patients with psoriatic arthritis (PsA) compared with the general population through a systematic review and meta-analysis of observational studies.

Methods:
We searched the Medline, Embase, and Cochrane databases, as well as abstracts archives from rheumatology conferences. Observational studies that included a PsA diagnosis, cardiovascular or cerebrovascular outcomes, and a comparison group of individuals without psoriasis and rheumatic diseases and were case–control, cross-sectional, or cohort studies, were assessed by 2 researchers. We calculated weighted pooled summary estimates of the maximally adjusted effect size estimates for cardiovascular and cerebrovascular diseases using the random-effects model, and tested for heterogeneity using the I2 statistic.

Results:
Eleven studies, comprising 32,973 patients with PsA, met the inclusion criteria. There was a 43% increased risk of cardiovascular diseases in patients with PsA compared with the general population (pooled odds ratio [OR] 1.43 [95% confidence interval (95% CI) 1.24–1.66]). The risk of incident cardiovascular events was increased by 55% (pooled OR 1.22–1.96). Morbidity risks for myocardial infarction, cerebrovascular diseases, and heart failure were increased by 68%, 22%, and 31%, respectively (pooled OR 1.68 [95% CI 1.31–2.15], pooled OR 1.22 [95% CI 1.05–1.41], and pooled OR 1.31 [95% CI 1.11–1.55], respectively). We identified significant heterogeneity in all main analyses (P < 0.001).

Conclusion:
Cardiovascular and cerebrovascular morbidity are increased by 43% and 22%, respectively, in patients with PsA compared with the general population.

Source: onlinelibrary.wiley.com

*Funding: Krembil Foundation and Canadian Institutes of Health Research

[D Foster]

I wonder if it's because of the lack of mobility therefore the tendency would be to be overweight and lack of exercise which is not helpful for those problems, I wonder if it's the same figure's for all types of arthritis.

[Fred]

I wonder if it's because of the lack of mobility therefore the tendency would be to be overweight and lack of exercise which is not helpful for those problems, I wonder if it's the same figure's for all types of arthritis.

Good point. It doesn't take weight into account and we all know extra weight is not good for psoriatic arthritis, neither is lack of exercise.

[Caroline]

I wonder if it's because of the lack of mobility therefore the tendency would be to be overweight and lack of exercise which is not helpful for those problems, I wonder if it's the same figure's for all types of arthritis.

Good point. It doesn't take weight into account and we all know extra weight is not good for psoriatic arthritis, neither is lack of exercise.

Tomorrow 19:00 I expect you both in Spinning class....

I read this before. If you do a good search you can find several seemingly good researches done at several places that mention this relation.
Still I certainly agree that you need to know more about the parameters of this research to be able to adequately interpret it.

[Fred]

Tomorrow 19:00 I expect you both in Spinning class....  

 

I read this before. If you do a good search you can find several seemingly good researches done at several places that mention this relation.

Yes by typing "Cardiovascular" in our very own search box you will find loads more.  

[jiml]

I wonder if it's because of the lack of mobility therefore the tendency would be to be overweight and lack of exercise which is not helpful for those problems, I wonder if it's the same figure's for all types of arthritis.

Good point. It doesn't take weight into account and we all know extra weight is not good for psoriatic arthritis, neither is lack of exercise.

Tomorrow 19:00 I expect you both in Spinning class....  

[D Foster]

The research that I can find is below and included many other types of problems such as spondylarthropathy patients, particularly ankylosing spondylitis and psoriatic arthritis so not just PsA. This I would suggest sways the figures as it is not only PsA.

Objective

To evaluate the cardiovascular risk profile of spondylarthropathy patients, particularly ankylosing spondylitis and psoriatic arthritis.

Methods

A pub med literature search was performed to collect English-language articles for this clinically orientated review. Studies were selected if they included (cardiovascular) mortality and morbidity and/or data about cardiovascular risk factors in spondylarthropathies.

Results

Ankylosing spondylitis as well as psoriatic arthritis appear to be associated with an increased cardiovascular mortality and morbidity. Several factors, ie, smoking, altered lipid profile, hypertension, increased fibrinogen level, enhanced number of platelets, and hypercoagulability might explain the enhanced cardiovascular risk. Moreover, a decline in physical activity, the presence of HLA-B27, and inflammation may play a role. Finally, undertreatment of cardiovascular morbidity also may contribute to the higher cardiovascular risk.

Conclusions

The available data indicate an increased cardiovascular risk in spondylarthropathy patients, particularly those with ankylosing spondylitis and psoriatic arthritis.

Relevance

Rheumatologists should be aware of the enhanced cardiovascular risk in patients with ankylosing spondylitis and psoriatic arthritis. If modifiable cardiovascular risk factors are identified, treatment could ultimately result in a lower cardiovascular morbidity and mortality.

[Caroline]

hypercoagulability might explain the enhanced cardiovascular risk. Moreover, a decline in physical activity,

Yes, hyper coagulability, an important fact... You have to keep you blood thin.. so.. Let's have a regular Merlot in the bar tonight. Freds strategy of going merlotose regularly is a very smart one.

as we are going off topic, we will continue this conversation in the bar as there is always [Group Specific]