Increased Risk for Cardiovascular Adverse Events in Patients with Hidradenitis Suppurativa

Summary and Comment |
March 15, 2016

Increased Risk for Cardiovascular Adverse Events in Patients with Hidradenitis Suppurativa

  1. Craig A. Elmets, MD

HS is a chronic inflammatory process, and patients also have increased frequency of obesity and diabetes, features favoring enhanced cardiovascular risk.

  1. Craig A. Elmets, MD

Hidradenitis suppurativa (HS), an inflammatory skin disorder with recurrent, draining abscesses occurring in the axillary, genital, and inframammary skin, is associated with increased expression of such inflammatory cytokines as interleukin (IL)-1α, tumor necrosis factor α, IL-10, and IL-17. Other inflammatory diseases (e.g., rheumatoid arthritis, psoriasis) are associated with increased risk for major adverse cardiovascular events and increased mortality. To determine whether cardiovascular morbidity and mortality are greater in people with HS, the authors compared 6000 HS patients without prior cardiovascular disease from the Danish National Patient Registry and age- and sex-matched controls for a mean of 7.1 years.

Incidences of myocardial infarction (unadjusted incident rate ratio, 2.18; confidence interval, 1.61–2.94), ischemic stroke (1.73; 1.32–2.25), cardiovascular-associated death (2.54; 1.87–3.44), major adverse cardiovascular events (2.07; 1.73–2.48) and all-cause mortality (1.96; 1.68–2.29) were significantly greater in HS patients than in the general population. HS patients were as likely to have experienced myocardial infarction, ischemic stroke, and all-cause mortality as those with severe psoriasis and had a greater rate of cardiovascular-associated deaths.

Comment

Patients with HS have a chronic inflammatory process; they also have an increased frequency of obesity and diabetes, features favoring enhanced risk for adverse cardiovascular events. Whether a cause-and-effect relationship or an association alone connects HS and cardiovascular effects remains to be determined. As with psoriasis patients, physicians should be vigilant for cardiovascular signs and symptoms in HS patients and should refer them to the appropriate specialists if warranted.

Editor Disclosures at Time of Publication

  • Disclosures for Craig A. Elmets, MD at time of publication Consultant / Advisory board Astellas Pharmaceuticals Equity Vaxin Grant / Research support NIH; NIH/NCI; Veteran’s Administration; Ferndale Laboratories; Kyowa Hakko Kirin Pharma, Inc. Editorial boards Cancer Prevention Research; Photodermatology, Photoimmunology, & Photomedicine; UpToDate; eMedicine; Journal of Dermatological Sciences; JAMA Dermatology Leadership positions in professional societies American Academy of Dermatology (Vice Chair, Committee on Science and Research); Photomedicine Society (Board of Directors)

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