Cardiovascular disease in psoriasis: Survey results from primary care physicians and cardiologists

Background: Current evidence suggests a higher prevalence of cardiovascular (CV) risk factors and events in psoriasis patients. The National Psoriasis Foundation guidelines recommend screening for CV risk factors starting at age 20. However, the current state of screening practices for CV risk factors by cardiologists and primary care physicians (PCPs) is unknown. Objective: We aimed to assess awareness among cardiologists and PCPs of the potentially increased risk of CVevents in psoriasis patients and to identify physician practice patterns of screening for CV risk factors in psoriasis patients. Methods:We distributed surveys to cardiologists and PCPs between October 1, 2010 and April 15, 2011. Physicians were randomly selected through professional society registries, which included the American College of Cardiology and the American Academy of Family Physicians. Univariable and multivariable logistic regression and two-sided McNemar's tests were used to compare results. Results: We received 60 (24%) responses from cardiologists and 191 (76%) responses from PCPs. Overall, 45% (113/251) of all physicians were aware that psoriasis was associated with an increased risk of CV events. Approximately 43% (108/251) of physicians reported screening psoriasis patients starting at age 20 for hypertension; 11% (27/251) reported screening for coronary artery disease, and 30% (75/251) reported screening for obesity. Cardiologists were 1.85 times more likely to be aware of an increased risk of CV events among psoriasis patients than PCPs (P =.039; 95% CI, 1.032-3.332). Compared to their awareness of CV comorbidities associated with psoriasis, both cardiologists and PCPs were significantly more aware of increased CV comorbidities associated with rheumatoid arthritis (P<.0001) and systemic lupus erythematosus (P<.0001). Conclusions: Fewer than half of surveyed cardiologists and PCPs screen psoriasis patients for CV risk factors. Cardiologists were more likely than PCPs to be cognizant of CV comorbidities in psoriasis patients. Both cardiologists and PCPs were less aware of CV comorbidities associated with psoriasis compared to those associated with rheumatoid arthritis and systemic lupus erythematosus.