The increased rates of cardiovascular morbidity and mortality in patients with psoriasis are not adequately explained by traditional risk factors. Whether concomitant sleep disorders modify the risk of cardiovascular disease in patients with psoriasis remains unknown.
Using the Taiwan National Health Insurance Research Database ( NHIRD ), researchers have conducted a cohort study to investigate the association between concomitant sleep disorders and cardiovascular disease risk in patients with psoriasis.
Data from 99,628 adults who received a psoriasis diagnosis during the period from 2004 to 2010 were analyzed.
Psoriasis patients with a concomitant sleep disorder had significantly higher risks of ischemic heart disease ( adjusted hazard ratio [aHR], 1.25; 95% confidence interval [ CI ], 1.22-1.28 ) and stroke ( aHR, 1.24; 95% CI, 1.16-1.33 ) as compared with psoriasis patients without sleep disorder.
All psoriasis patient subgroups, including those with mild and severe psoriasis and those with and without arthritis, had increased hazard ratios for ischemic heart disease and stroke.
The increases in ischemic heart disease and stroke risks conferred by sleep disorders were proportional to the dose of hypnotics used. The effect of sleep disorders on the risks of ischemic heart disease and stroke was greater in young adults than in middle-aged and older adults.
In conclusion, the risks of ischemic heart disease and stroke were higher for psoriasis patients with sleep disorders than for those without sleep disorders.
Clinicians should carefully evaluate cardiovascular risk, particularly in young patients with psoriasis. ( Xagena )
Chiu HY et al, PLoS One 2016;11:e0146462. doi: 10.1371/journal.pone.0146462.