Combined Psoriasis, High Blood Pressure Linked to Doubled Mortality Risk

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Patients with both psoriasis and high blood pressure are a doubled risk of all-cause mortality, according to recent research.

An international team of investigators conducted a prospective cohort study to examine the synergistic effect of psoriasis and hypertension on mortality among US adults. They noted that previous research discovered a compounding link between psoriasis and hypertension as detrimental conditions—yet not much was discovered on the combined effects of psoriasis and hypertension on all-cause mortality.

“Our objective was to unravel the intricate connections among psoriasis, hypertension, and mortality through a meticulous analysis of data derived from the (National Health and Nutrition Examination Study [NHANES]) spanning the periods 2003–2006 and 2009–2014,” wrote the investigators. “This study marks a pioneering effort, representing the first exploration into the collective impact of psoriasis and hypertension on mortality.”

Investigators used NHANES data spanning both 2003 – 2006, as well as 2009 – 2014. A psoriasis diagnosis was self-reported, and a hypertension diagnosis was confirmed by specific parameters such as a systolic blood pressure of at least 140 mmHg, diastolic blood pressure at least 90 mmHg, a physician-reported diagnosis, or the use of antihypertensive medication.

The study included 19,799 participants; 554 had psoriasis (2.8 percent) and 7692 (38.9 percent) had hypertension. Also, among participants with hypertension, 276 had a historical record of psoriasis.

The sample (mean age, 45 years) were 49.9 percent male; 69% identified as non-Hispanic white. Individuals with both hypertension and psoriasis had a greater likelihood of being female, non-Hispanic white, and former smokers. Those with only psoriasis had a greater likelihood of being non-Hispanic white and former smokers.

Investigators used multivariable logistic regression analyses to assess the mortality outcome of the combined efforts of psoriasis and hypertension. The analyses revealed patients with psoriasis had an increased risk of hypertension, compared with those without psoriasis.

During a medium follow-up period of approximately eight years (105 months), 1,845 participants faced all-cause mortality. Participants with both psoriasis and hypertension had an approximate two-fold increase in all-cause mortality risk, which was a greater risk than patients with just psoriasis or hypertension.

“It is crucial to emphasize that the existence of psoriasis can serve as a substantial supplementary risk factor for all-cause mortality in the context of hypertension,” investigators wrote. “These results bear significant implications, underscoring the potential critical role of screening for psoriasis in augmenting the life expectancy of individuals with hypertension.”

A stratified analysis distinguishing between the presence with and without psoriasis saw hypertension correlated with an increased risk of all-cause mortality in individuals without psoriasis. Additionally, this correlation was also seen among individuals with psoriasis.

“Our findings illuminate a substantial elevation in the risk of all-cause mortality among individuals simultaneously grappling with psoriasis and hypertension, a phenomenon that persists even following rigorous adjustments for demographic factors (sex, age, race, education, marital status), BMI category, smoking status, drinking status, and diabetes,” investigators wrote. “These results not only underscore the exigency of targeted psoriasis screening within the hypertensive demographic but also lay a robust foundation for further exploration in both foundational and clinical research.”

An original version of this article was published by sister site HCPLive.