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

Abstract

Background: Psoriasis has been shown to be associated with cardiovascular disease in adults. Little is known about cardiovascular risk in pediatric psoriasis.

Objective: To determine if there is an association between pediatric psoriasis and cardiovascular comorbidities.

Methods: 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.

Results: 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.

Limitations: The study was limited to hospitalized children. We were unable to assess the impact of psoriasis treatment or family history on cardiovascular risk.

Conclusion: 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.

Keywords: arrhythmia; cardiovascular risk factors; comorbidities; diabetes; hyperlipidemia; hypertension; obesity; psoriasis; racial differences.