Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, 1600 N.W. 10th Avenue, Miami, FL 33136, USA.
J Gen Intern Med. 2011 Sep;26(9):1036-49. doi: 10.1007/s11606-011-1698-5. Epub 2011 Apr 7.
Psoriasis afflicts 2-3% of the world's population. Affected patients commonly have risk factors for cardiovascular disease (CVD). In addition, psoriasis is independently associated with CVD and mortality.
To determine which CVD risk factors are associated with psoriasis independent of confounders, whether psoriasis is associated with CVD independent of CVD risk factors, and whether there is increased mortality among patients with psoriasis.
MEDLINE, Embase, and Cochrane Collaborations from inception through October 2009. We reviewed bibliographies of retrieved articles for additional references.
Cross-sectional, cohort-based, case-control, and randomized controlled trials which involved patients with psoriasis.
Two investigators independently reviewed studies and resolved any discrepancies by consensus.
Of the 2,303 articles identified by literature search, 90 studies met inclusion criteria for this review; 15 were cohort-based studies, 45 were case-control, and 30 were cross-sectional.
The quality of evidence was limited by study heterogeneity and lack of large scale prospective studies with long-term follow-up.
Patients with psoriasis demonstrate a higher prevalence of cardiovascular risk factors and appear to be at increased risk for ischemic heart disease, cerebrovascular disease, and peripheral arterial disease. This increase in vascular disease may be independent of shared risk factors and may contribute to the increase in all-cause mortality. Future research should aim to more confidently distinguish between a true causal relationship or merely an association resulting from multiple shared risk factors. Physicians should screen for and aggressively treat modifiable risk factors for CVD in patients with psoriasis.
银屑病影响了全球 2-3%的人口。受影响的患者通常具有心血管疾病（CVD）的风险因素。此外，银屑病与 CVD 和死亡率独立相关。
确定哪些 CVD 风险因素与银屑病独立于混杂因素相关，银屑病是否与 CVD 独立于 CVD 风险因素相关，以及银屑病患者的死亡率是否增加。
从建立到 2009 年 10 月的 MEDLINE、Embase 和 Cochrane 合作数据库。我们审查了检索到的文章的参考文献，以获取其他参考文献。
涉及银屑病患者的横断面、队列研究、病例对照和随机对照试验。
两位研究人员独立审查了研究，并通过共识解决了任何分歧。
通过文献搜索确定了 2303 篇文章，其中 90 项研究符合本综述的纳入标准；其中 15 项为队列研究，45 项为病例对照研究，30 项为横断面研究。
证据质量受到研究异质性和缺乏大规模前瞻性研究长期随访的限制。
银屑病患者表现出更高的心血管风险因素患病率，并且似乎存在更高的缺血性心脏病、脑血管病和外周动脉疾病风险。这种血管疾病的增加可能独立于共同的风险因素，并可能导致全因死亡率的增加。未来的研究应旨在更有信心地区分真正的因果关系或仅仅是由于多种共同风险因素而导致的关联。医生应在银屑病患者中筛查和积极治疗可改变的 CVD 风险因素。
