Cardiovascular comorbidities in patients with psoriatic arthritis: a systematic review
Annals of Rheumatic Diseases,
Evidence Based Medicine
Jamnitski A et al. – Most studies point towards an increased cardiovascular risk in PsA, broadly on a par with the risk level in rheumatoid arthritis, emphasising the need for similar cardiovascular risk management in both conditions.Methods
- Medline, EMBASE and the Cochrane library were searched from January 1966 to April 2011 for English language articles on data concerning cardiovascular diseases and cardiovascular risk factors in PsA.
- Review articles, case reports and studies on psoriasis alone were excluded.
- Twenty–eight articles were included in this review.
- Studies on all–cause mortality revealed mixed results.
- Available data on cardiovascular disease appeared more consistent, indicating an increased cardiovascular mortality and morbidity in PsA.
- Commensurate with this, surrogate markers of subclinical atherosclerosis, arterial stiffness and cardiovascular risk factors, for example hypertension, dyslipidaemia, obesity and metabolic–related factors, were more prominent in PsA compared with controls.
- Suppression of inflammation was linked with a favourable effect on cardiovascular surrogate markers, for example carotid intima media thickness and endothelial dysfunction, in several (un)controlled studies.