Psoriasis is associated with subsequent atrial fibrillation in hypertensive patients with left ventricular hypertrophy: the Losartan Intervention For Endpoint study

Casper N Bang; Peter M Okin; Lars Køber; Kristian Wachtell; Alice Bendix Gottlieb; Richard B Devereux

doi:10.1097/HJH.0000000000000078

Psoriasis is associated with subsequent atrial fibrillation in hypertensive patients with left ventricular hypertrophy: the Losartan Intervention For Endpoint study

Casper N Bang, Peter M Okin, Lars Køber, Kristian Wachtell, Alice Bendix Gottlieb, Richard B Devereux

15 Citations (Scopus)

Abstract

BACKGROUND: Inflammation contributes to the pathogenesis of psoriasis as well as atrial fibrillation. The impact of psoriasis and its association with new-onset atrial fibrillation was assessed in hypertensive patients with left ventricular hypertrophy (LVH).

METHODS: The predictive value of baseline or incident psoriasis for new-onset atrial fibrillation was evaluated in 7099 hypertensive patients with electrocardiographic LVH with no history of atrial fibrillation or other cardiovascular disease, in sinus rhythm on their baseline electrocardiogram.

RESULTS: A total of 154 patients (2.2%) had or developed psoriasis and new-onset atrial fibrillation occurred in 506 patients (7.1%) during a mean follow-up of 4.7 ± 1.1 years. At baseline, the psoriasis patients were younger (65 ± 7 vs. 67 ± 7 years) and had less left ventricle hypertrophy by ECG Sokolow-Lyon voltage (27.6 ± 9.7 vs. 30.1 ± 10.4 mm); higher hemoglobin (6.3 ± 2.2 vs. 6.0 ± 2.7 mmol/l) and prevalence of diabetes (20.6 vs. 12.8%, P ≤ 0.004) than patients without psoriasis. In multivariable Cox analysis, adjusting for age, sex, hemoglobin, diabetes, time-varying SBP, heart rate, study treatment and Sokolow-Lyon hypertrophy, psoriasis, treated as a time-varying covariate, was associated with a two-fold higher risk of new-onset atrial fibrillation [hazard ratio: 1.97 (95% confidence interval (CI): 1.18-3.30), P=0.01]. Propensity-matched analysis yielded similar results (odds ratio: 3.49, 95% CI 1.24-9.81, P=0.018).

CONCLUSION: Psoriasis has a similar prevalence in hypertensive patients as in the general population. Psoriasis independently predicted new-onset atrial fibrillation despite lower age and electrocardiographic LVH in psoriasis patients than in patients without psoriasis.

Original language	English
Journal	Journal of Hypertension
Volume	32
Issue number	3
Pages (from-to)	667-72
Number of pages	6
ISSN	0263-6352
DOIs	https://doi.org/10.1097/HJH.0000000000000078
Publication status	Published - Mar 2014

Keywords

Aged
Angiotensin II Type 1 Receptor Blockers
Antihypertensive Agents
Atrial Fibrillation
Double-Blind Method
Female
Humans
Hypertension
Hypertrophy, Left Ventricular
Losartan
Male
Middle Aged
Prospective Studies
Psoriasis
Risk Factors
Treatment Outcome

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1097/HJH.0000000000000078

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Psoriasis is associated with subsequent atrial fibrillation in hypertensive patients with left ventricular hypertrophy: the Losartan Intervention For Endpoint study. / Bang, Casper N; Okin, Peter M; Køber, Lars et al.
In: Journal of Hypertension, Vol. 32, No. 3, 03.2014, p. 667-72.

Research output: Contribution to journal › Journal article › Research › peer-review

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title = "Psoriasis is associated with subsequent atrial fibrillation in hypertensive patients with left ventricular hypertrophy: the Losartan Intervention For Endpoint study",

abstract = "BACKGROUND: Inflammation contributes to the pathogenesis of psoriasis as well as atrial fibrillation. The impact of psoriasis and its association with new-onset atrial fibrillation was assessed in hypertensive patients with left ventricular hypertrophy (LVH).METHODS: The predictive value of baseline or incident psoriasis for new-onset atrial fibrillation was evaluated in 7099 hypertensive patients with electrocardiographic LVH with no history of atrial fibrillation or other cardiovascular disease, in sinus rhythm on their baseline electrocardiogram.RESULTS: A total of 154 patients (2.2%) had or developed psoriasis and new-onset atrial fibrillation occurred in 506 patients (7.1%) during a mean follow-up of 4.7 ± 1.1 years. At baseline, the psoriasis patients were younger (65 ± 7 vs. 67 ± 7 years) and had less left ventricle hypertrophy by ECG Sokolow-Lyon voltage (27.6 ± 9.7 vs. 30.1 ± 10.4 mm); higher hemoglobin (6.3 ± 2.2 vs. 6.0 ± 2.7 mmol/l) and prevalence of diabetes (20.6 vs. 12.8%, P ≤ 0.004) than patients without psoriasis. In multivariable Cox analysis, adjusting for age, sex, hemoglobin, diabetes, time-varying SBP, heart rate, study treatment and Sokolow-Lyon hypertrophy, psoriasis, treated as a time-varying covariate, was associated with a two-fold higher risk of new-onset atrial fibrillation [hazard ratio: 1.97 (95% confidence interval (CI): 1.18-3.30), P=0.01]. Propensity-matched analysis yielded similar results (odds ratio: 3.49, 95% CI 1.24-9.81, P=0.018).CONCLUSION: Psoriasis has a similar prevalence in hypertensive patients as in the general population. Psoriasis independently predicted new-onset atrial fibrillation despite lower age and electrocardiographic LVH in psoriasis patients than in patients without psoriasis.",

keywords = "Aged, Angiotensin II Type 1 Receptor Blockers, Antihypertensive Agents, Atrial Fibrillation, Double-Blind Method, Female, Humans, Hypertension, Hypertrophy, Left Ventricular, Losartan, Male, Middle Aged, Prospective Studies, Psoriasis, Risk Factors, Treatment Outcome",

author = "Bang, {Casper N} and Okin, {Peter M} and Lars K{\o}ber and Kristian Wachtell and Gottlieb, {Alice Bendix} and Devereux, {Richard B}",

year = "2014",

month = mar,

doi = "10.1097/HJH.0000000000000078",

language = "English",

volume = "32",

pages = "667--72",

journal = "Journal of Hypertension",

issn = "0263-6352",

publisher = "Lippincott Williams & Wilkins, Ltd.",

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TY - JOUR

T1 - Psoriasis is associated with subsequent atrial fibrillation in hypertensive patients with left ventricular hypertrophy

T2 - the Losartan Intervention For Endpoint study

AU - Bang, Casper N

AU - Okin, Peter M

AU - Køber, Lars

AU - Wachtell, Kristian

AU - Gottlieb, Alice Bendix

AU - Devereux, Richard B

PY - 2014/3

Y1 - 2014/3

N2 - BACKGROUND: Inflammation contributes to the pathogenesis of psoriasis as well as atrial fibrillation. The impact of psoriasis and its association with new-onset atrial fibrillation was assessed in hypertensive patients with left ventricular hypertrophy (LVH).METHODS: The predictive value of baseline or incident psoriasis for new-onset atrial fibrillation was evaluated in 7099 hypertensive patients with electrocardiographic LVH with no history of atrial fibrillation or other cardiovascular disease, in sinus rhythm on their baseline electrocardiogram.RESULTS: A total of 154 patients (2.2%) had or developed psoriasis and new-onset atrial fibrillation occurred in 506 patients (7.1%) during a mean follow-up of 4.7 ± 1.1 years. At baseline, the psoriasis patients were younger (65 ± 7 vs. 67 ± 7 years) and had less left ventricle hypertrophy by ECG Sokolow-Lyon voltage (27.6 ± 9.7 vs. 30.1 ± 10.4 mm); higher hemoglobin (6.3 ± 2.2 vs. 6.0 ± 2.7 mmol/l) and prevalence of diabetes (20.6 vs. 12.8%, P ≤ 0.004) than patients without psoriasis. In multivariable Cox analysis, adjusting for age, sex, hemoglobin, diabetes, time-varying SBP, heart rate, study treatment and Sokolow-Lyon hypertrophy, psoriasis, treated as a time-varying covariate, was associated with a two-fold higher risk of new-onset atrial fibrillation [hazard ratio: 1.97 (95% confidence interval (CI): 1.18-3.30), P=0.01]. Propensity-matched analysis yielded similar results (odds ratio: 3.49, 95% CI 1.24-9.81, P=0.018).CONCLUSION: Psoriasis has a similar prevalence in hypertensive patients as in the general population. Psoriasis independently predicted new-onset atrial fibrillation despite lower age and electrocardiographic LVH in psoriasis patients than in patients without psoriasis.

AB - BACKGROUND: Inflammation contributes to the pathogenesis of psoriasis as well as atrial fibrillation. The impact of psoriasis and its association with new-onset atrial fibrillation was assessed in hypertensive patients with left ventricular hypertrophy (LVH).METHODS: The predictive value of baseline or incident psoriasis for new-onset atrial fibrillation was evaluated in 7099 hypertensive patients with electrocardiographic LVH with no history of atrial fibrillation or other cardiovascular disease, in sinus rhythm on their baseline electrocardiogram.RESULTS: A total of 154 patients (2.2%) had or developed psoriasis and new-onset atrial fibrillation occurred in 506 patients (7.1%) during a mean follow-up of 4.7 ± 1.1 years. At baseline, the psoriasis patients were younger (65 ± 7 vs. 67 ± 7 years) and had less left ventricle hypertrophy by ECG Sokolow-Lyon voltage (27.6 ± 9.7 vs. 30.1 ± 10.4 mm); higher hemoglobin (6.3 ± 2.2 vs. 6.0 ± 2.7 mmol/l) and prevalence of diabetes (20.6 vs. 12.8%, P ≤ 0.004) than patients without psoriasis. In multivariable Cox analysis, adjusting for age, sex, hemoglobin, diabetes, time-varying SBP, heart rate, study treatment and Sokolow-Lyon hypertrophy, psoriasis, treated as a time-varying covariate, was associated with a two-fold higher risk of new-onset atrial fibrillation [hazard ratio: 1.97 (95% confidence interval (CI): 1.18-3.30), P=0.01]. Propensity-matched analysis yielded similar results (odds ratio: 3.49, 95% CI 1.24-9.81, P=0.018).CONCLUSION: Psoriasis has a similar prevalence in hypertensive patients as in the general population. Psoriasis independently predicted new-onset atrial fibrillation despite lower age and electrocardiographic LVH in psoriasis patients than in patients without psoriasis.

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KW - Angiotensin II Type 1 Receptor Blockers

KW - Antihypertensive Agents

KW - Atrial Fibrillation

KW - Double-Blind Method

KW - Female

KW - Humans

KW - Hypertension

KW - Hypertrophy, Left Ventricular

KW - Losartan

KW - Male

KW - Middle Aged

KW - Prospective Studies

KW - Psoriasis

KW - Risk Factors

KW - Treatment Outcome

U2 - 10.1097/HJH.0000000000000078

DO - 10.1097/HJH.0000000000000078

M3 - Journal article

C2 - 24379001

SN - 0263-6352

VL - 32

SP - 667

EP - 672

JO - Journal of Hypertension

JF - Journal of Hypertension

IS - 3

ER -

Psoriasis is associated with subsequent atrial fibrillation in hypertensive patients with left ventricular hypertrophy: the Losartan Intervention For Endpoint study

Abstract

Keywords

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