Psoriasis and risk of heart failure: a nationwide cohort study

Eur J Heart Fail. 2014 Jul;16(7):743-8. doi: 10.1002/ejhf.113. Epub 2014 Jun 5.


Aims: Psoriasis is a common inflammatory disease that is associated with increased risk of cardiovascular disease, including myocardial infarction. Heart failure (HF) is independently associated with several cardiovascular risk factors and is a major cause of cardiovascular morbidity and mortality. The association between psoriasis and HF is unclear and we therefore investigated the risk of new-onset HF in a nationwide cohort of psoriasis patients compared with the background population.

Methods: The study included the entire Danish population aged ≥18 years followed from 1 January 1997 until HF, death or 31 December 2011. Information on comorbidity and concomitant medication was identified by individual-level linkage of administrative registers. New-onset HF was defined as first hospital admission for HF. Incidence rates of new-onset HF were calculated and adjusted hazard ratios were estimated by multivariable Cox regression models adjusted for age, gender, comorbidity and cardiovascular medications.

Results: A total of 5 485 856 subjects were eligible for analysis. In the study period 66 389 patients with new-onset psoriasis, including 11 242 patients with severe psoriasis, were identified. The overall incidence rates of new-onset HF were 2.82, 4.22 and 4.70 per 1000 person-years for the reference population, mild psoriasis and severe psoriasis, respectively. Compared with the reference population, the fully adjusted hazard ratios for new-onset HF were increased in patients with psoriasis with a hazard ratio 1.22 (95% confidence interval 1.16-1.29) and hazard ratio of 1.53 (95% confidence interval 1.34-1.74) for those with mild and severe disease, respectively.

Conclusion: In this nationwide cohort, psoriasis was associated with a disease severity-dependent increased risk of new-onset HF.

Keywords: Cardiovascular risk; Epidemiology; Heart failure; Inflammation; Psoriasis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antirheumatic Agents / therapeutic use
  • Arthritis, Psoriatic / epidemiology
  • Cardiovascular Agents / therapeutic use
  • Cohort Studies
  • Denmark / epidemiology
  • Heart Failure / drug therapy
  • Heart Failure / epidemiology*
  • Humans
  • Middle Aged
  • Multivariate Analysis
  • Proportional Hazards Models
  • Psoriasis / drug therapy
  • Psoriasis / epidemiology*
  • Risk Factors
  • Severity of Illness Index
  • Young Adult


  • Antirheumatic Agents
  • Cardiovascular Agents