New study finds link between high blood pressure and psoriasis

Patients with moderate to severe psoriasis are also more likely to have uncontrolled hypertension than those not suffering from the common skin condition, according to new research appearing in the October 15 online edition of the journal JAMA Dermatology.
Researchers from the University of Pennsylvania Perelman School of Medicine, Thomas Jefferson University in Philadelphia, and the National Heart, Lung, and Blood Institute (NHLBI) in Bethesda, Maryland examined the effect of psoriasis and its severity on blood pressure control among patients diagnosed as having hypertension.
The study authors recruited 1,322 patients with psoriasis and hypertension and 11,977 controls with hypertension but without psoriasis. They discovered “a significant positive dose-response relationship between uncontrolled hypertension and psoriasis severity as objectively determined by the affected body surface area,” meaning that the likelihood of uncontrolled blood pressure increased along with the severity of the skin condition.
As such, they reported that the likelihood of uncontrolled hypertension was the highest in patients suffering from moderate to severe psoriasis, defined by the researchers as three percent or more of the body surface area affected by the condition. The results held true even when controlled for age, sex, body mass index and other factors, and suggest the need for more effective blood pressure management in psoriasis patients.
“Over the last several years, studies have shown that psoriasis, specifically severe psoriasis, is an independent risk factor for a variety of comorbidities, putting patients suffering with this common skin disease at an increased risk for other conditions such as heart attack and stroke,” Junko Takeshita, co-first author of the new study, explained in a statement Thursday.
“Knowing that psoriasis is tied to other health conditions, it’s vital that we have a better understanding of the systemic effects it has on other areas of the body so that we can more closely monitor these patients and provide better and preventative care,” added Takeshita, a clinical instructor in the Penn Medicine department of dermatology.
For the purposes of the study, the researchers defined uncontrolled hypertension as blood pressure measured as at least 140/90, and examined data from a random sample of psoriasis patients included in a UK-based electronic medical database known as The Health Improvement Network (THIN). Takeshita said that the psoriasis diagnostic code in the THIN database had been validated through several research studies analyzing the condition.
“To our knowledge, ours is the first study to evaluate the effect of objectively determined psoriasis severity on blood pressure control,” Takeshita said. While the research has found a strong correlation between hypertension and psoriasis, it does not prove whether psoriasis could cause hypertension or whether the opposite is true. However, she noted that this new study is a good launching pad for future studies probing that issue.
“Determining the cause and effect is something that needs to be evaluated in future longitudinal studies so that we can better assess which condition developed first,” she said. “Our hypothesis is that the psoriasis and the inflammation that comes with it are making the hypertension worse, but certainly it could go the other way, and understanding which comes first has important implications for how we care for these patients and our understanding of how these two conditions are related.”
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