Cardiovascular comorbidities of pediatric psoriasis among hospitalized children in the United States

• Published in: Journal of the American Academy of Dermatology Vol. 77; no. 6; pp. 1023 - 1029
• Main Authors: Kwa, Lauren, Kwa, Michael C., Silverberg, Jonathan I.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-12-2017
• Subjects: Adolescent; arrhythmia; Cardiovascular Diseases - complications; Cardiovascular Diseases - epidemiology; cardiovascular risk factors; Child; Child, Preschool; comorbidities; diabetes; Female; Hospitalization; Humans; hyperlipidemia; hypertension; Infant; Male; obesity; psoriasis; Psoriasis - complications; racial differences; Risk Factors; United States; hyperlipidemia; comorbidities; ICD-9-CM; arrhythmia; psoriasis; racial differences; NIS; cardiovascular risk factors; diabetes; hypertension; obesity
• ISSN: 0190-9622; 1097-6787
• DOI: 10.1016/j.jaad.2017.08.034

Psoriasis has been shown to be associated with cardiovascular disease in adults. Little is known about cardiovascular risk in pediatric psoriasis.
To determine if there is an association between pediatric psoriasis and cardiovascular comorbidities.
Data were analyzed from the 2002-2012 Nationwide Inpatient Sample, which included 4,884,448 hospitalized children aged 0-17 years. Bivariate and multivariate survey logistic regression models were created to calculate the odds of psoriasis on cardiovascular comorbidities.
In multivariate survey logistic regression models adjusting for age, sex, and race/ethnicity, pediatric psoriasis was significantly associated with 5 of 10 cardiovascular comorbidities (adjusted odds ratio [95% confidence interval]), including obesity (3.15 [2.46-4.05]), hypertension (2.63 [1.93-3.59]), diabetes (2.90 [1.90-4.42]), arrhythmia (1.39 [1.02-1.88]), and valvular heart disease (1.90 [1.07-3.37]). The highest odds of cardiovascular risk factors occurred in blacks and Hispanics and children ages 0-9 years, but there were no sex differences.
The study was limited to hospitalized children. We were unable to assess the impact of psoriasis treatment or family history on cardiovascular risk.
Pediatric psoriasis is associated with higher odds of multiple cardiovascular comorbidities among hospitalized patients. Strategies for mitigating excess cardiovascular risk in pediatric psoriasis need to be determined.