Background/Purpose: The prevalence of cardiovascular diseases (CVD) is higher in patients with psoriatic disease. Psoriatic disease is known to be an independent risk factor for the development of CVD. CVD knowledge and risk perception is a key predictor of patients’ likelihood of adopting a healthy lifestyle. However, it is not clear whether patients with psoriatic disease have adequate knowledge and what the barriers are that prevent them from understanding CVD risk. Thus, the aim of this cross-sectional study was to assess psoriatic patients’ knowledge and perception of CVD and examine their relationship with demographic and clinical characteristics. 

Methods: Psoriatic arthritis (PsA) patients, who have had psoriasis diagnosis confirmed by a dermatologist, were recruited from the PsA clinic. Patients with psoriasis without PsA (PsC), were diagnosed by a dermatologist and evaluated by a rheumatologist to exclude PsA. All patients completed the knowledge level questionnaire based on the validated Heart Disease Fact Questionnaire for Rheumatoid Arthritis (HDFQ-RA), and risk perception was measured by the validated Perception of Risk of Heart Disease Scale (PRHDS). Framingham Risk Score was calculated as a measure of the estimated risk of CVD. The relationships between CVD knowledge and variables such as perceived risk, estimated risk, demographic and clinical characteristics were examined with Spearman correlation. 

Results: 200 patients (102 PsA and 98 PsC), who did not have a history of CVD, completed the questionnaire (Mean age = 51.9±13.6 years, 53% females and 78% Caucasians). The mean score in CVD knowledge among psoriatic patients was 60.4% (SD±15.5). Patients scored significantly lower (p < 0.001) in questions addressing psoriatic-specific risk factors and CVD symptoms (Mean score = 42.2% and 43.4%, respectively) as compared to questions on traditional risk factors and diet (Mean score = 68.8% and 71.5%, respectively). CVD knowledge was found to have a significant correlation with education level (Spearman’s rho r_s = 0.271, p < 0.001). Significant difference in knowledge level was found between patients who only completed grade school (Mean score = 43%) and those who completed post-secondary degrees (Mean score = 62.7%) (p = 0.001). Furthermore, CVD knowledge level and perception of risk has a weak but significant positive correlation (r_s = 0.277, p < 0.001). No significant correlation between patients’ perceived risk and estimated CVD risk was found (r_s = 0.157, p= 0.221). 

Conclusion: Improving CVD knowledge and risk perception and developing CVD risk reduction interventions are imperative for psoriatic patients. Educational programs on psoriatic-specific risk factors and CVD symptoms might help encourage active participation in disease management and maintenance of healthy lifestyle, particularly among patients with lower education level.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/knowledge-and-perception-of-cardiovascular-disease-risk-in-patients-with-psoriatic-disease/