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Are eczema patients at an increased risk of cardiovascular disease?
Are adults with atopic dermatitis (eczema) at an increased risk of cardiovascular disease? A matched cohort study undertaken in the UK looked at this topic, and also investigated whether the risk varies by eczema severity and condition activity over time.
Looking at health records from 1998 to 2015, the study matched adults with a diagnosis of eczema to up to five patients without the condition. They were matched on age, sex, general practice and time. In total, 387,439 patients with eczema were matched to 1,528,477 patients without the condition. The average age was 43 years and 66 per cent of patients were female. The average follow-up time was 5.1 years.
Cardiovascular outcomes were measured, including myocardial infarction, unstable angina, heart failure, atrial fibrillation, stroke, and cardiovascular death.
Evidence of a 10 to 20 per cent increased hazard for the non-fatal primary outcomes for patients with eczema was found. There was a strong dose-response relation with severity of eczema. Patients with a severe case of the condition had a 20 per cent increase in the risk of stroke (hazard ratio 1.22, 99% confidence interval 1.01 to 1.48), 40 to 50 per cent increase in the risk of myocardial infarction, unstable angina, atrial fibrillation, and cardiovascular death, and 70 per cent increase in the risk of heart failure (hazard ratio 1.69, 99% confidence interval 1.38 to 2.06). Patients with the most active eczema were also at a greater risk of cardiovascular outcomes.
The study concluded that severe and predominantly active atopic dermatitis (eczema) are associated with an increased risk of cardiovascular outcomes.
It proposed that targeting cardiovascular disease prevention strategies among these patients should be considered.
Silverwood Richard J, Forbes Harriet J, Abuabara Katrina, Ascott Anna, Schmidt Morten, Schmidt Sigrún A J et al. Severe and predominantly active atopic eczema in adulthood and long term risk of cardiovascular disease: population based cohort study. BMJ. 2018; 361 :k1786
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