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Hypertension, antihypertensive medication use, and risk of psoriasis.

ABSTRACT: Individuals with psoriasis have an elevated risk of hypertension, and antihypertensive medications, especially ?-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.To evaluate the association of hypertension and antihypertensive medications with risk of psoriasis.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.Physician-diagnosed psoriasis.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 ?-blockers, the multivariate HRs for psoriasis for women who regularly used ?-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.Long-term hypertensive status is associated with an increased risk of psoriasis. Long-term regular use of ?-blockers may also increase the risk of psoriasis.

SUBMITTER: Wu S

PROVIDER: S-EPMC4184206 | biostudies-literature | 2014 Sep

REPOSITORIES: biostudies-literature

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Hypertension, antihypertensive medication use, and risk of psoriasis.

Wu Shaowei S Han Jiali J Li Wen-Qing WQ Qureshi Abrar A AA

JAMA dermatology 20140901 9

<h4>Importance</h4>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.<h4>Objective</h4>To evaluate the association of hypertension and antihypertensive medications with risk of psoriasis.<h4>Design, setting, and partic ...[more]

PMID: 24990147

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Project description:BACKGROUND:Adherence to medication has been repeatedly proposed to represent a major cause of treatment-resistant hypertension (TRH); however, treatment decisions such as treating TRH with renal denervation depend on accurate judgment of adherence. We carefully analyzed adherence rates to medication before and after renal denervation and its effect on blood pressure (BP) control. METHODS AND RESULTS:Eighty patients with TRH were included in 2 prospective observational studies that assessed the difference of potential antihypertensive and nephroprotective effects of renal denervation. To compare prescribed with actual medication intake (representing a measure of adherence), we analyzed urine samples collected at baseline and at 6 months after renal denervation for antihypertensive compounds or metabolites (by liquid chromatography-mass spectrometry). In addition to office BP, 24-hour ambulatory BP and central hemodynamics (central systolic pressure, central pulse pressure) were assessed. Informed consent for analyses of urine metabolites was obtained from 79 of 80 patients. Actual intake of all antihypertensive drugs was detected at baseline and at 6 months after renal denervation in 44 (56%) and 52 (66%) patients, respectively; 1 drug was missing in 22 (28%) and 17 (22%) patients, respectively, and ?2 drugs were missing in 13 (16%) and 10 (13%) patients, respectively. At baseline, 24-hour ambulatory BP (P=0.049) and central systolic BP (P=0.012) were higher in nonadherent patients. Adherence did not significantly change overall (McNemar-Bowker test, P=0.362). An increase in adherence was observed in 21 patients, and a decrease was observed in 11 patients. The decrease in 24-hour ambulatory BP was not different in those with stable adherence 6 months after renal denervation (n=41, -7±13 mm Hg) compared with those with increased adherence (n=21, -10±13 mm Hg) and decreased adherence (n=11, -7±14 mm Hg) (P>0.20). Our study is limited by the relatively small sample size and potentially by the specific health environment of our university center (Northern Bavaria, Germany). CONCLUSIONS:Nonadherence to medication among patients with TRH was relatively low: ?1 of 6 patients with TRH did not take ?2 of the prescribed drugs. Adherence pattern did not change significantly after renal denervation and had no impact on the overall observed BP changes, supporting the concept that renal denervation is an effective treatment in patients with TRH. CLINICAL TRIAL REGISTRATION:URL: https://www.clinicaltrials.gov. Unique identifiers: NCT00888433, NCT01442883 and NCT01687725.

Dataset Information

Hypertension, antihypertensive medication use, and risk of psoriasis.

Publications

Hypertension, antihypertensive medication use, and risk of psoriasis.

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