A significant proportion of patients with psoriasis and psoriatic arthritis (PsA) are underdiagnosed and undertreated for cardiovascular risk factors (CVRF), according to Lihi Eder, MD, of the University of Toronto, and her associates.

In a cross-sectional analysis published in the Journal of Rheumatology , researchers examined 2,254 patients (58.9% with PsA, 41.1% with psoriasis only) from eight centers in Canada, the United States, and Israel. They found that 1,017 of the patients had hypertension (PsA: 48.5%, psoriasis: 40.2%), including 233 who were not previously diagnosed with hypertension and were not taking any blood pressure–lowering medications (PsA: 19.9%, psoriasis: 39.1%). Many patients had low adherence to hypertension treatment recommendations: A total of 602 (PsA: 55.9%, psoriasis: 64.8%) were untreated or undertreated. Undertreatment of hypertension occurred in 60.9% patients with cardiovascular disease or diabetes mellitus.

In addition, 623 patients (49.4%) had dyslipidemia. Of those patients, 35.8% were not previously diagnosed with dyslipidemia (PsA: 33.6%, psoriasis: 40.3%). These patients also had low adherence to treatment recommendations: only 34.4% reported using lipid-lowering drugs (PsA: 36.2%, psoriasis: 31.2%). Adherence was higher in patients with clinical CVD (79%) and diabetes (61.5%).

“In this large international study, we found significant gaps in screening and treating CVRF in patients with psoriasis and PsA,” the researchers concluded. “Although questions exist regarding the optimal treatment targets for CVRF in psoriatic patients, adherence by physicians to, at a minimum, the general treatment recommendations for primary CV prevention is warranted.”

SOURCE: Eder L et al. J Rheumatol. 2018 Feb 1. doi: 10.3899/jrheum.170379 .