Usefulness of the Framingham risk score in patients with chronic psoriasis

Psoriasis is a chronic inflammatory skin disease associated with increased cardiovascular morbidity and mortality. The Framingham risk score is a validated and composite measurement that predicts the absolute risk of developing major cardiovascular events at 5 and 10 years. The objective of this study was to estimate the Framingham cardiovascular risk score in patients with psoriasis. A cross-sectional study in 234 adult patients with psoriasis and 234 age- and gender-matched patients with skin diseases other than psoriasis was performed. The Framingham risk score includes age, gender, total cholesterol, high-density lipoprotein cholesterol, systolic blood pressure, smoking status, and diabetes mellitus. Framingham risk score was significantly higher in patients with psoriasis than in controls at 5 years (mean ± SD 5.3 ± 4.4 vs 3.4 ± 3.3, p <0.001) and at 10 years (11.2 ± 8.1 vs 7.3 ± 6.3, p <0.001). The risk was higher for patients >50 years of age. Patients with psoriasis were more frequently smokers and diabetics and had more commonly atherogenic dyslipidemia than controls (p <0.05). Presence of psoriasis was independently associated with a higher Framingham score (coefficient 1.6, 95% confidence interval [CI] 0.6 to 2.5, p = 0.001). There was no correlation between severity or duration of psoriasis and Framingham risk score (coefficient 0.009, 95% CI -0.02 to 0.04, p = 0.6; coefficient 0.02, 95% CI 0.007 to 0.04, p = 0.7, respectively). In conclusion, patients with psoriasis have an intermediate risk of developing major cardiovascular events and thus interventions aimed to correct modifiable cardiovascular risk factors are warranted.