Psoriasis and Hypertension Severity Results from a Case-Control Study 英文参考文献.docVIP

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Psoriasis and Hypertension Severity Results from a Case-Control Study 英文参考文献.doc

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Psoriasis and Hypertension Severity Results from a Case-Control Study 英文参考文献

PsoriasisandHypertensionSeverity:ResultsfromaCase- ControlStudy AprilW.Armstrong1*,StevenW.Lin1,CynthiaJ.Chambers1,MaryE.Sockolov1,DavidL.Chin2 1Department of Dermatology, University of California Davis, Sacramento, California, United States of America, 2Center for Healthcare Policy and Research, Graduate GroupinEpidemiology,UniversityofCaliforniaDavis,Sacramento,California,UnitedStatesofAmerica Abstract Background:Epidemiologicstudieshaveprovidednewinsightsintotheassociationbetweenpsoriasisandcardiovascular diseases. Previous population studies have examined hypertension frequency in psoriasis patients. However, the relationshipbetweenseverityofhypertensionandpsoriasishasnotbeencharacterized. Objective:Wesoughttoinvestigatewhetherpatientswithpsoriasishavemoredifficult-to-managehypertensioncompared tonon-psoriatichypertensivepatients. Approach:Weperformedacase-controlstudyusingtheUniversityofCaliforniaDaviselectronicmedicalrecords.Thecases were defined as patients diagnosed with both psoriasis and hypertension, and controls were defined as patients with hypertensionandwithoutpsoriasis.Inthisidentifiedpopulation,835caseswerematchedonage,sex,andbodymassindex (BMI)to2418controlpatients. KeyResults:Treatmentwithmultipleanti-hypertensiveswassignificantlyassociatedwiththepresenceofpsoriasisusing univariate (p,0.0001) and multivariable analysis, after adjusting for diabetes, hyperlipidemia, and race (p,0.0001). Comparedtohypertensivepatientswithoutpsoriasis,psoriasispatientswithhypertensionwere5timesmorelikelytobeon amonotherapyantihypertensiveregimen(95%CI3.607.05),9.5timesmorelikelytobeondualantihypertensivetherapy (95%CI6.68–13.65),16.5timesmorelikelytobeontripleantihypertensiveregimen(95%CI11.01–24.84),and19.9times more likely to be on quadruple therapy or centrally-acting agent (95% CI 10.58–37.33) in multivariable analysis after adjustingfortraditionalcardiacriskfactors. Conclusions: Psoriasis patients appear to have more difficult-to-control hypertension compare