SOURCE: Chiu HY, Lo PC, Huang WF, et al. Increased risk of aortic aneurysm (AA) in relation to the severity of psoriasis: A national population-based matched-cohort study. J Am Acad Dermatol 2016;75:747-754.
Approximately 15,000 people per year die in the United States from ruptured abdominal aortic aneurysms (AAA). The commonly recognized risk factors for AAA include hypertension, smoking, male sex, and age. While the link between inflammatory disorders, such as rheumatoid arthritis and psoriasis, and coronary vascular disease has received increasing attention in the last decade, little cognizance exists of a relationship between psoriasis and AAA.
To define this relationship further, Chiu et al reviewed the medical records of 34,301 patients with psoriasis in a Taiwanese database. When age and sex matched with controls (n = 137,204), a surprisingly strong association between psoriasis and risk for AAA emerged.
Patients with psoriasis were almost twice as likely (hazard ratio = 1.8) to be diagnosed with AAA as controls. Further substantiating the relationship, psoriasis severity was associated linearly with increasing risk for AAA. The strong association was independent of the already recognized risk factors for vasculopathy such as hypertension, smoking, and dyslipidemia. The authors suggested consideration of screening for AAA in psoriasis patients because of increased risk. Current U.S. Preventive Services Task Force guidelines suggest a one-time ultrasound screening for men between 65-75 years of age who are ever smokers (≥ 100 lifetime cigarettes).