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July 16, 2014
High Blood Pressure, Use Of Beta Blockers Increases Women’s Psoriasis Risk

Providence, RI—Long-term high blood pressure increases women’s risk of psoriasis, especially if they also have extensively used beta blockers to treat their hypertension, according to a new analysis of the Nurses Health Study conducted from 1996 to 2008.

The report on the link between hypertension and related medications with psoriasis, an immune-related skin disease that affects about 3% of the U.S. population, was published recently in JAMA Dermatology. Background in the article notes that antihypertensive medications, especially beta-blockers, have been linked to psoriasis in the past but that adequate retrospective information has been lacking.

“Individuals with psoriasis have an elevated risk of hypertension, and antihypertensive medications, especially beta blockers, have been linked to psoriasis development,” the authors write. “However, the association of prior existing hypertension and antihypertensive medications with risk of incident psoriasis has not been assessed using prospective data.”

Reviewing records from a group of 77,728 women who were part of the Nurses’ Health Study, Brown University-led researchers identified a total of 843 incident cases of psoriasis diagnosed by physicians.

Results indicate that women with hypertension for 6 years or more were at a higher risk for developing psoriasis compared with women with normal blood pressure. In addition, the risk of psoriasis was higher among women with high blood pressure, whether or not they took medication, compared with women with normal blood pressure. A higher risk for psoriasis also was found among women who regularly used beta blockers for 6 years or longer, although no increased risk was found with other antihypertensive medications.

Specifically, compared with women without high blood pressure, women with a hypertension duration of six years or more were at a higher risk of developing psoriasis (hazard ratio [HR],?1.27; 95% CI, 1.03-1.57). Compared with women who never used beta blockers, the multivariate hazard ratios for psoriasis for women who regularly used beta blockers were 1.11 (95% CI, 0.82-1.51) for 1 to 2 years of use, 1.06 (95% CI, 0.79-1.40) for 3 to 5 years of use, and 1.39 (95% CI, 1.11-1.73) for 6 years or more of use.

“These findings provide novel insights into the association among hypertension, antihypertensive medications and psoriasis. However, further work is necessary to confirm our findings and clarify the biological mechanisms that underlie these associations,” researchers point out.

In a related editorial, April W. Armstrong, MD, MPH, of the University of Colorado, Denver, comments, “A critical practice gap exists in identifying the causes of psoriasis flares, especially medication-related causes. Some physicians may not consistently examine medications for their contribution to psoriasis flares. However, a careful consideration of the role of medications in psoriasis exacerbation may improve long-term psoriasis control.”





U.S. Pharmacist Social Connect