PATIENTS with hidradenitis suppurativa (HS) have an increased likelihood of developing cardiovascular disease (CVD), according to the most extensive study evaluating the association between HS and CVD. Patients with HS are often diagnosed with comorbid disorders, including hyperlipidaemia, diabetes, and metabolic syndromes, associated with increased susceptibility to CVD. Moreover, the formation of atherosclerotic plaques, and therefore, the development of atherosclerosis is impacted by systemic inflammation, as it can drive endothelial dysfunction.
Researchers conducted a large-scale propensity-matched global retrospective cohort study analysing CVD risk in patients diagnosed with HS. The study comprised 144,100 patients with HS and 144,100 healthy controls matched for demographics and all diseases recognised as CVD risk factors. The authors used a ≥1% appearance, based on absolute numbers, of CVD to identify the presence of the cardiovascular event in both cohorts.
The study identified a total of 90 CVDs within the cohorts, belonging to six groups: heart failure, ischaemic heart and brain disease, vascular disorders, conduction disorders, valve disorders, and disorders of myo- and pericardial disease. Although patients with HS displayed higher rates of obesity, nicotine dependency, and diabetes, there were lower odds of primary hypertension in patients with HS compared to healthy controls. Nevertheless, HS was associated with an increased risk of the onset of 47 CVDs (P=0.0001), specifically unspecified heart failure (hazard ratio: 2.1; 95% confidence interval: 1.95–2.269) and myocardial infarction (hazard ration: 2.06; 95% confidence interval: 1.88–2.27) showed the highest risk. Investigators acknowledged study limitations, such as not examining HS severity and additional disease characteristics, as well as the sample size not taking place in one centre.
The study authors concluded that patients with HS are at a significantly greater risk of developing CVD, particularly heart failure and myocardial infarction. Therefore, the treatment of HS must be comprehensive and incorporate both dermatologists and cardiologists. Furthermore, surveillance and implementing CVD prophylaxis in all HS patients can prevent life-threatening conditions.
Reference
Krajewski PK et al. Risk of cardiovascular disorders in hidradenitis suppurativa patients: a large‐scale, propensity‐matched global retrospective cohort study. International Journal of Dermatology. 2024;DOI:10.1111/ijd.17186.
