Cardiovascular Risk Among Patients With Moderate-to-Severe Plaque Psoriasis in Southern Sri Lanka: A Case-Control Study.

INTRODUCTION

Psoriasis is a chronic inflammatory skin condition associated with increased cardiovascular (CV) risk and a higher prevalence of comorbidities. The study aimed to assess CV risk and contributory factors in patients with chronic plaque psoriasis (CPP).

METHODS

This case-control study included 80 patients with CPP attending selected dermatology clinics in Southern Sri Lanka, along with 80 age- and sex-matched controls from their neighbourhood. Data on demographic and disease-related factors were collected using an interviewer-administered questionnaire from consecutive patients with moderate to severe psoriasis, as defined by body surface area (BSA) and the Psoriasis Area and Severity Index (PASI). Anthropometric measurements, blood glucose, and lipid assays were conducted for both groups. Comorbidity was assessed using the Charlson Comorbidity Index (CCI) while CV risk was estimated using the Framingham Risk Score (FRS) and the Atherosclerotic Cardiovascular Disease (ASCVD) 10-year risk score.

RESULTS

Mean (standard deviation, or SD) age of patients with CPP (n=80) was 51 (11) years, with 41 being male. The corresponding values of controls were 50 (10) years, with 41 being male. The median (interquartile range, or IQR) duration of psoriasis was 10 (6-20) years, median (IQR) BSA was 11.3% (5.5-20.4%), and median (IQR) PASI was 6.7 (5.3-10.8). Patients with psoriasis had a higher median CCI value (1 (1-3) vs. 0 (1-2); U=1819, p < 0.001) and higher occurrence of dyslipidaemia (odds ratio (OR) 5.69; confidence interval (CI): 2.03-15.93) compared to controls. Patients with CPP had higher triglycerides (TG) and triglyceride-to-high-density lipoprotein (TG/HDL) ratios compared to controls (p < 0.05 for both). Although CV risk scores were higher among patients with CPP, they did not differ significantly from those of controls.

CONCLUSION

Patients with CPP have higher comorbidity and unadjusted lipid levels. This highlights the need to educate healthcare professionals to adopt a more holistic approach in evaluating patients with CPP.