Risk for Psoriasis Associated With Hypertension and Its Treatment
RESEARCH · July 02, 2014
TAKE-HOME MESSAGE
- In this prospective cohort study using data from participants in the Nurses’ Health Study, the authors found a small, but significant, increased risk for psoriasis in individuals with hypertension for ≥6 years and in those on beta blockers for ≥6 years. However, other antihypertensive medications were not found to be associated with increased risk for psoriasis.
- Long-term use of beta blockers increases the risk for developing psoriasis. Consultation with the prescribing physician should occur for patients with suspected beta blocker–exacerbated or –induced psoriasis prior to drug cessation.
ABSTRACT
IMPORTANCE
Individuals with psoriasis have an elevated risk of hypertension, and antihypertensive medications, especially β-blockers, have been linked to psoriasis development. However, the association of prior existing hypertension and antihypertensive medications with risk of incident psoriasis has not been assessed using prospective data.
OBJECTIVE
To evaluate the association of hypertension and antihypertensive medications with risk of psoriasis.
DESIGN, SETTING, AND PARTICIPANTS
We performed a prospective cohort study (June 1, 1996, to June 1, 2008) of 77 728 US women from the Nurses’ Health Study who provided biennially updated data on hypertension and antihypertensive medications.
MAIN OUTCOMES AND MEASURES
Physician-diagnosed psoriasis.
RESULTS
A total of 843 incident psoriasis cases were documented during 1 066 339 person-years of follow-up. Compared with normotensive women, women with a hypertension duration of 6 years or more were at a higher risk of developing psoriasis (hazard ratio [HR], 1.27; 95% CI, 1.03-1.57). In stratified analysis, the risk of psoriasis was higher among hypertensive women without medication use (HR, 1.49; 95% CI, 1.15-1.92) and among hypertensive women with current medication use (HR, 1.31; 95% CI, 1.10-1.55) when compared with normotensive participants without medication use. Compared with women who never used β-blockers, the multivariate HRs for psoriasis for women who regularly used β-blockers were 1.11 (95% CI, 0.82-1.51) for 1 to 2 years of use, 1.06 (95% CI, 0.79-1.40) for 3 to 5 years of use, and 1.39 (95% CI, 1.11-1.73) for 6 years or more of use (P for trend = .009). No association was found between use of other individual antihypertensive drugs and risk of psoriasis.
CONCLUSIONS AND RELEVANCE
Long-term hypertensive status is associated with an increased risk of psoriasis. Long-term regular use of β-blockers may also increase the risk of psoriasis.
Related Items
Psoriasis Risk Rises in Women with History of Hypertension and Beta-Blocker Use
Metabolic Syndrome, Insulin Resistance Occur Frequently in Psoriatic Arthritis Patients
JAMA dermatology (Chicago, Ill.)
Hypertension, Antihypertensive Medication Use, and Risk of Psoriasis
JAMA Dermatol 2014 Jul 02;[EPub Ahead of Print], S Wu, J Han, WQ Li, AA Qureshi