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Prevalence of cardiovascular-related comorbidity in ankylosing spondylitis, psoriatic arthritis and psoriasis in primary care: a matched retrospective cohort study

Abstract

The aim of this study is to compare the prevalence of cardiovascular (CVD)-related comorbidities in patients with ankylosing spondylitis (AS), psoriatic arthritis (PsA) or psoriasis (Ps) in UK primary care against matched cohorts. Matched retrospective cohort study used a primary care consultation database. Three cohorts were constructed using all patients with a Read code diagnosis of AS, PsA or Ps between 1999 and 2009; each cohort was then compared in a 1:4 ratio to a matched cohort. The prevalence of CVD-related comorbidities (hypertension, ischaemic heart disease, hyperlipidaemia and diabetes mellitus) were identified by the first consultation of a comorbid Read code, in those with an inflammatory condition of interest. The prevalence of CVD-related comorbidities was compared between each inflammatory cohort and their matched cohort using Fisher’s exact test. Ninety-four AS, 106 PsA and 290 Ps patients were identified. Compared with matched cohorts, the most prevalent CVD-related comorbidity in patients with AS was hypertension (35 (37.2 %) vs. 96 matched (25.5 %), p = 0.03); this was also the case for PsA (41 (38.7 %) vs. 114 matched (26.9 %), p = 0.02). No differences were seen in the prevalence of other CVD-related comorbidities in those with AS, PsA or Ps compared to their matched cohorts. Our findings provide UK comparisons of CVD-related comorbidities in patients with AS, PsA and Ps alone; specifically, demonstrating increased prevalence of hypertension in AS and PsA cohorts compared to their matched cohorts. This further supports the argument for more evidence in the need for screening and intervention around CVD comorbidities in inflammatory conditions.

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Acknowledgments

I would like to thank the Keele GP Research Partnership and the Informatics team at the Arthritis Research UK Primary Care Centre for providing the CiPCA dataset. CiPCA is funded by the North Staffordshire Primary Care Research Consortium and Keele University Institute for Primary Care and Health Sciences.

Author contributions

Contribution statement: Guarantor of overall study integrity: JAP, RH, CDM and SH. Study concept and design: JAP, RH & SH. Data collection and interpretation: NA, YC and JAP. Statistical analysis NA, YC and JAP. Manuscript preparation: NA, JAP, YC, RH, CDM and SH. Final approval of manuscript: NA, JAP, YC, RH, CDM and SH.

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Correspondence to James A. Prior.

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Funding

JAP is funded by a Launching Fellowship from the NIHR School for Primary Care Research. CDM is funded by the National Institute for Health Research (NIHR) Collaborations for Leadership in Applied Health Research and Care West Midlands, the NIHR School for Primary Care Research and a NIHR Research Professorship in General Practice (NIHR-RP-2014-04-026). The study sponsors had no role in study design; in the collection, analysis and interpretation of data; in the writing of the report and in the decision to submit the paper for publication. The views and opinions expressed therein are those of the authors and do not necessarily reflect those of the NIHR (UK). This paper presents independent research which is part-funded by the CLAHRC West Midlands. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health.

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The CiPCA dataset (and any subsequent studies) was granted ethical approval by the North Staffordshire Research Ethics Committee.

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Ahmed, N., Prior, J.A., Chen, Y. et al. Prevalence of cardiovascular-related comorbidity in ankylosing spondylitis, psoriatic arthritis and psoriasis in primary care: a matched retrospective cohort study. Clin Rheumatol 35, 3069–3073 (2016). https://doi.org/10.1007/s10067-016-3362-2

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Keywords

  • Ankylosing spondylitis
  • Cardiovascular disease
  • Primary care
  • Psoriasis
  • Psoriatic arthritis