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Are patients with psoriasis being screened for cardiovascular risk factors? A study of screening practices and awareness among primary care physicians and cardiologists - 11/08/12

Doi : 10.1016/j.jaad.2011.09.006 
Kory K. Parsi, BS a, d, Elizabeth A. Brezinski, BA a, Tzu-Chun Lin, MS b, Chin-Shang Li, PhD c, April W. Armstrong, MD, MPH a,
a Department of Dermatology, University of California, Davis, Sacramento, California 
b Department of Statistics, University of California, Davis, Sacramento, California 
c Department of Public Health Sciences, University of California, Davis, Sacramento, California 
d AT Still University-School of Osteopathic Medicine in Arizona, Mesa, Arizona 

Reprint requests: April W. Armstrong, MD, MPH, Department of Dermatology, University of California Davis Health System.

Abstract

Introduction

Increasing literature suggests that patients with psoriasis who have severe disease appear to have increased frequency of cardiovascular (CV) diseases. The National Psoriasis Foundation recommends screening for CV risk factors as early as 20 years of age. The extent to which these screening guidelines are implemented in practice is unclear.

Objective

We sought to assess CV risk factor screening practices in patients with psoriasis and to assess primary care physician (PCP) and cardiologist awareness of worse CV outcomes in patients with psoriasis.

Methods

We distributed 1200 questionnaires to PCPs and cardiologists between October 1, 2010, and April 15, 2011. A representative national sample of physicians was obtained by random selection from professional medical societies.

Results

A total of 251 PCPs and cardiologists responded to the questionnaire. Among these physicians, 108 (43%) screened for hypertension, 27 (11%) screened for dyslipidemia, 75 (30%) screened for obesity, and 67 (27%) screened for diabetes. Physicians who cared for a greater number of patients with psoriasis were significantly more likely to screen for CV risk factors (hypertension P = .0041, dyslipidemia P = .0143, and diabetes P = .0065). Compared with PCPs, cardiologists were 3.5 times more likely to screen for dyslipidemia (95% confidence interval 1.32-9.29, P = .012). A total of 113 (45%) physicians were aware that psoriasis was associated with worse CV outcomes.

Limitations

The questionnaire response rate was modest.

Conclusions

Most PCPs and cardiologists did not routinely screen patients with psoriasis for CV risk factors. Educating physicians regarding potentially increased CV risk in psoriasis and adopting a multidisciplinary approach in the care of patients with psoriasis will likely lead to improved patient outcomes.

Le texte complet de cet article est disponible en PDF.

Key words : cardiovascular disease, clinical practice, comorbidities, coronary artery disease, myocardial infarction, psoriasis, screening

Abbreviations used : AHA, AJC, CI, CV, NPF, OR, PCP, RA, SLE


Plan


 Statistical support for this publication was made possible by grant UL1 RR024146 from the National Center for Research Resources (NCRR), a component of the National Institutes of Health (NIH), and NIH Roadmap for Medical Research. Its contents are solely the responsibility of the authors and do not necessarily represent the official view of NCRR or NIH. Information on Re-engineering the Clinical Research Enterprise can be obtained from overview-translational.asp.
 Disclosure: Dr Armstrong is an investigator and consultant to Abbott and Janssen. Mr Parsi, Ms Brezinski, Ms Lin, and Dr Li have no conflicts of interest to declare.
 Other correspondence to: aprilarmstrong@post.harvard.edu.


© 2011  American Academy of Dermatology, Inc.. Publié par Elsevier Masson SAS. Tous droits réservés.
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Vol 67 - N° 3

P. 357-362 - septembre 2012 Retour au numéro
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  • Comorbidities significantly impact patients’ preferences for psoriasis treatments
  • Astrid Schmieder, Marthe-Lisa Schaarschmidt, Nasir Umar, Darcy D. Terris, Matthias Goebeler, Sergij Goerdt, Wiebke K. Peitsch

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