Prevalence Of Selected Cardiovascular Risk Factors Among Patients With Psoriasis Vulgaris At The Kenyatta National Hospital
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.