Background/Purpose:

Psoriatic arthritis (PsA) is a chronic inflammatory arthritis associated with the presence of psoriasis. Both conditions are influenced by lifestyle factors such as alcohol consumption, smoking and obesity. Furthermore, there is evidence that PsA is associated with an increased risk of cardiovascular disease (CVD) compared to the general population. The aim of this study was i) to compare lifestyle factors between individuals with PsA, psoriasis and a control group and ii) to assess the relationship between these inflammatory diseases and CVD outcomes.

Methods:

UK Biobank recruited 502,664 people aged 40-70 years in the UK between 2006 and 2010. Cross-sectional data on lifestyle, sociodemographics, and health and medical history were collected at the assessment visit by questionnaire and interview by a research nurse. Participants were asked if they have ever been diagnosed by a physician with PsA, psoriasis or any other disease. Lifestyle factors including alcohol (current or past intake) and smoking status (ever or never) were recorded and height and weight measured to calculate BMI. In this cross-sectional study, the frequency of these factors was compared between PsA, psoriasis and healthy controls using logistic or linear regression analyses depending on the outcome, adjusting for age and gender. Comparison between disease groups was performed by linear combinations of coefficients post estimation. Three CVD outcomes: heart attack, angina and hypertension, were tested for association with disease group using logistic regression including BMI, smoking, alcohol, age and gender as covariates. Odds ratios (OR) and β coefficients are reported with 95% confidence intervals (CI).

Results:

A total of 476,626 participants were included; 862 participants with PsA, 4,761 participants with psoriasis and 471,003 control participants (Table). Compared with the control group; both the PsA and psoriasis groups had higher BMI (β 1.43 (95% CI 1.11-1.75) and 0.72 (0.58-0.85) respectively), the psoriasis group smoked more (OR 1.63 (1.54-1.72)) and the PsA group had a lower rate of current drinkers (OR 0.68 (0.55-0.85)). Comparing between disease groups; the PsA group had a higher BMI (β 0.69 (0.32-1.06)) and lower rates of both ever smoking and current alcohol consumption (OR 0.70 (0.61-0.81) and 0.65 (0.51-0.83) respectively). Finally, hypertension was more prevalent in PsA compared to the control and psoriasis cohorts (OR 1.71 (1.48-1.97) and 1.55 (1.33-1.82) respectively).

Conclusion: Using a large population based cohort we have shown that self-reported rates of hypertension are significantly higher in patients with PsA compared with psoriasis independently of known CVD risk factors. The results contribute to our understanding of the lower quality of life reported by patients with PsA.