Rutter, MK and Kane, K and Lunt, M and Cordingley, L and Littlewood, A and Young, HS and Chew-Graham, CA and Hilton, R and Symmons, DPM and Griffiths, CEM (2016) Primary care-based screening for cardiovascular risk factors in patients with psoriasis. British Journal of Dermatology, 175 (2). 348 -356. ISSN 1365-2133

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Abstract

BACKGROUND: Studies assessing cardiovascular disease (CVD) risk factors in patients with psoriasis have been limited by selection bias, inappropriate controls or a reliance on data collected for clinical reasons. OBJECTIVES: To investigate whether screening for CVD risk factors in patients with psoriasis in primary care augments the known prevalence of CVD risk factors in a cross-sectional study. METHODS: Patients listed as having psoriasis in primary care were recruited, screened and risk assessed by QRISK2. RESULTS: In total, 287 patients attended (mean age 53 years, 57% women, 94% white British, 22% severe disease, 33% self-reported psoriatic arthritis). The proportion with known and screen-detected (previously unknown) risk factors was as follows: hypertension 35% known and 13% screen-detected; hypercholesterolaemia 32% and 37%; diabetes 6·6% and 3·1% and chronic kidney disease 1·1% and 4·5%. At least one screen-detected risk factor was found in 48% and two or more risk factors were found in 21% of patients. One in three patients (37%) not previously known to be at high risk were found to have a high (> 10%) 10-year CVD risk. Among the participants receiving treatment for known CVD risk factors, nearly half had suboptimal levels for blood pressure (46%) and cholesterol (46%). CONCLUSIONS: Cardiovascular risk factor screening of primary care-based adults with psoriasis identified a high proportion of patients (i) at high CVD risk, (ii) with screen-detected risk factors and (iii) with suboptimally managed known risk factors. These findings need to be considered alongside reports that detected limited responses of clinicians to identified risk factors before universal CVD screening can be recommended.

Item Type: Article
Additional Information: This is the final published version of the article (version of record). It first appeared online via Wiley at http://dx.doi.org/10.1111/bjd.14557 - please refer to any applicable terms of use of the publisher.
Uncontrolled Keywords: arthritis, psoriatic, cardiovascular diseases, cross-sectional studies, diabetes complications, England, female, humans, hypercholesterolemia, hypertension, male, middle aged, prevalence, psoriasis, renal insufficiency, chronic, risk factors, self report
Subjects: R Medicine > R Medicine (General)
Divisions: Faculty of Medicine and Health Sciences > Primary Care Health Sciences
Related URLs:
Depositing User: Symplectic
Date Deposited: 26 Sep 2017 13:19
Last Modified: 26 Sep 2017 13:20
URI: http://eprints.keele.ac.uk/id/eprint/4051

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