Women with a 6-year or longer history of hypertension, and women with a 6-year or longer use of beta-blocker medications to treat hypertension, may be at increased risk of developing psoriasis, compared with women who have normal blood pressure, according to data from more than 77,000 women.
"Women with hypertension tended to be older; had higher [body mass indexes]; had proportionately higher prevalence rates of cardiovascular disease, type 2 diabetes, and hypercholesterolemia; and were less physically active than those without hypertension," the researchers wrote.
The report was published online July 2 in JAMA Dermatology [doi:10.1001/jamadermatol.2013.9957].
Dr. Shaowei Wu of Brown University, Providence, R.I., and colleagues performed a prospective cohort study of 77,728 women participating in the Nurses’ Health Study between June 1996 and June 2008. The women provided biennially updated data on hypertension and antihypertensive medications. The researchers identified 843 psoriasis cases during more than 1 million person-years of follow-up.
Women with hypertension lasting 6 years or more were at higher risk of developing psoriasis than were normotensive women [HR 1.27]. In further analysis, researchers found "a higher risk of psoriasis among hypertensive women without medication use [HR 1.49] and among hypertensive women with current medication use [HR 1.31] when compared with normotensive women without medication use." In an analysis of individual antihypertensive medications, beta-blockers were the only drugs associated with psoriasis development. Although this association disappeared in a fully-adjusted model, it "persisted in a duration-dependent manner" [HR 1.39] among women taking the medications for 6 years or more, and this trend was statistically significant.
"Special attention on psoriasis screening may be needed for patients with long-term duration of hypertension and related antihypertensive medication use in clinical practices," the authors wrote. The findings "provide novel insights into the association among hypertension, antihypertensive medications, and psoriasis," they said. "However, further work is necessary to confirm our findings and clarify the biological mechanisms that underlie these associations."
The study was supported in part by the National Institutes of Health. Senior author Dr. Abrar Qureshi has served as a consultant for Abbott, Centocor, Novartis, and the Centers for Disease Control and Prevention.