Prevalence Of Selected Cardiovascular Risk Factors Among Patients With Psoriasis Vulgaris At The Kenyatta National Hospital
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Date
2012Author
Irungu, Caroline S
Type
ThesisLanguage
enMetadata
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Background: Psoriasis Vulgaris is a chronic, immune mediated inflammatory disease of the skin
associated with a high degree of morbidity and poor quality of life. Psoriasis has been reported
to be associated with an unfavorable cardiovascular risk profile. Moreover, the risk of mortality
is also increased patients with severe psoriasis compared to the general population.
Study Objective: We set out to determine the prevalence of selected cardiovascular risk factors
in patients with psoriasis vulgaris attending the dermatology clinic and dermatology inpatients
and healthy controls at the Kenyatta National Hospital.
Methods: This was a hospital based cross-sectional study carried out at the Kenyatta National
Hospital comparing psoriasis vulgaris cases from the dermatology clinic and dermatology ward
with age sex matched healthy controls from the blood transfusion unit over a three month
period. Study participants were interviewed using a questionnaire on socio-demographic
information, duration of psoriasis and treatment modality used and history of Hypertension,
Dyslipidaemia, Diabetes Mellitus, Obesity and Cigarette Smoking. Anthropometric and blood
pressure measurements were taken. Blood samples for blood sugar and total cholesterol were
drawn.
Results: Between July and October 2012 a total of 580 files of patients attending the
dermatology clinic and those admitted to the dermatology ward were reviewed. Of these, 92
files identified patients with psoriasis vulgaris and were screened.75 patients met the inclusion
criteria and were recruited as cases into the study. For the controls, a total of 82 healthy blood
donors were screened and 77 met the inclusion criteria. The mean age in the psoriasis vulgaris
population was 41.1 years and 40.9 years in the controls. There was a slight male
preponderance with a male to female ratio of 3.3:2.Hypertension was the most prevalent
cardiovascular risk factor in patients with psoriasis vulgaris at 40% and 22% in healthy controls.
hypertension was higher in psoriasis vulgaris cases than healthy controls (OR 2.4 [95% CI 1.2-
4.8] p=0.017) The prevalence of other selected cardiovascular risk factors in psoriasis vulgaris
patients and healthy age sex matched controls and their odds ratios were as follows:
Dyslipidaemia(25.35%, 20.8%, OR 1.3[95% CI 0.6-2.8] p =0.505), Diabetes (12%, 10.4%, OR 1.2
xi
[95% CI 0.4-3.2] p=0.753), Obesity (12%, 9.1%, OR 1.7[95% CI 0.6-4.8]p= 0.351 ), Abdominal
obesity (26.7%, 19.5%, OR 1.5[95% CI 0.7-3.2] p=0.293) and Cigarette smoking (6.8%, 6.5%, OR
1.1 [95% CI 0.3-4.1] p=0.273).There was no difference in the prevalence of these cardiovascular
risk factors between psoriasis vulgaris cases and healthy age-sex matched controls.
Conclusion: Hypertension was the most prevalent cardiovascular risk factor in psoriasis vulgaris
patients and the prevalence was higher in the cases compared to healthy controls. There was a
high prevalence of dyslipidaemia, diabetes mellitus, obesity and smoking in psoriasis vulgaris
patients but there was no difference between psoriasis vulgaris cases and controls as these did
not reach statistical significance. Blood pressure assessment as a primary prevention strategy to
prevent development of cardiovascular disease should be emphasized in psoriasis vulgaris
patients.
Citation
Master Of Medicine In Internal Medicine Of The University Of Nairobi, 2012Publisher
University of Nairobi, School of Medicine,