VITILIGO, a chronic skin disorder affecting 0.5–2% of the global population, involves melanocyte destruction due to complex genetic, autoimmune, and oxidative factors. While traditionally viewed as an aesthetic issue, emerging evidence suggests vitiligo, particularly its non-segmental form, may be a systemic disease linked to various comorbidities, including thyroid disorders, psoriasis, and metabolic syndrome. Recently, the relationship between vitiligo and cardiovascular diseases (CVDs) has garnered attention, though findings remain inconsistent across studies.
A retrospective analysis using a US-based electronic health record database evaluated 94 cardiovascular diagnoses in individuals with vitiligo. Of these, 54 showed an increased risk compared to controls. Conditions such as cerebral infarction, acute myocardial infarction, pulmonary embolism, and venous thrombosis were more prevalent among those with vitiligo. These findings suggest a heightened risk of major cardiovascular events (MACE), contrasting with prior studies, including a Korean cohort, which reported a lower risk of CVD-related mortality among vitiligo patients.
Notably, the study identified increased risks of ischemic heart diseases and heart failure in vitiligo patients. This aligns with observations in other autoimmune skin conditions like lupus but diverges from findings in psoriasis. Additionally, sick sinus syndrome, previously undocumented in vitiligo research, emerged as the cardiovascular condition with the highest hazard ratio.
Atherosclerosis also appears linked to vitiligo, with studies highlighting increased carotid intima-media thickness and a higher prevalence of atherosclerotic plaques. Hypertensive chronic kidney disease was another complication significantly associated with vitiligo. These risks may stem from systemic inflammation inherent in the disease, particularly in severe cases of non-segmental vitiligo.
The study underscores the need for further research to determine causal links between vitiligo and cardiovascular risks. Inflammatory mechanisms, disease severity, and treatment options, such as immunosuppressants or UVB therapy, may influence outcomes. While the findings highlight a significant health burden, prospective studies are essential to clarify these associations and inform clinical management strategies for patients with vitiligo.
Reference
Frączek A et al. Vitiligo is associated with an increased risk of cardiovascular diseases: a large-scale, propensity-matched, US-based retrospective study. EBioMedicine. 2024;109:105423.
