Certain Eczema Patients Have Elevated CV Risk
Individuals with severe and predominantly active atopic eczema have an increased risk for cardiovascular disease (CVD), a new study indicates.1
Severe eczema joins an ever-expanding list of chronic conditions—such as rheumatoid arthritis, severe psoriasis, and psoriatic arthritis—that may be associated with an increased CV risk, especially in those with severe disease activity.2
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For their study, the researchers evaluated 387,439 patients with atopic eczema, along with 1,528,477 matched controls. Median follow-up lasted 5.1 years.
Patient data were obtained from UK electronic health records within the Clinical Practice Research Datalink, Hospital Episode Statistics, and the Office for National Statistics between 1998 and 2015.
CV events—including myocardial infarction (MI), unstable angina, heart failure (HF), atrial fibrillation (AF), stroke, and CV death—comprised the primary outcome of the study.
Based on Cox regression findings, patients with atopic eczema appeared to have a 10% to 20% increased risk for the non-fatal primary outcomes compared with controls.
A strong dose-response relationship was observed based on the severity of atopic eczema. Patients with severe atopic eczema were found to have a 20% increased risk for stroke (hazard ratio [HR] 1.22); a 40% to 50% increased risk for MI, unstable angina, AF, and CV death; and a 70% increased risk for HF (HR 1.69).
An increased risk for CV outcomes was also observed among patients with the most active atopic eczema—defined as having active eczema for more than half of follow-up.
Point estimates were partially attenuated following additional adjustment for cardiovascular risk factors as potential mediators, but associations persisted for severe atopic eczema, the researchers noted.
With these findings in mind, the researchers concluded that “targeting cardiovascular disease prevention strategies among [patients with atopic eczema] should be considered.”
—Christina Vogt
Reference:
1. Silverwood RJ, Forbes HJ, Abuabara K, et al. Severe and predominantly active atopic eczema in adulthood and long-term risk of cardiovascular disease: population based cohort study [Published online May 23, 2018]. BMJ. https://doi.org/10.1136/bmj.k1786
2. Ingram JR. Atopic eczema and cardiovascular disease [Published online May 23, 2018]. BMJ. https://doi.org/10.1136/bmj.k2064
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