Are patients with psoriasis being screened for cardiovascular risk factors? A study of screening practices and awareness among primary care physicians and cardiologists

Abstract

Introduction: Increasing literature suggests that patients with psoriasis who have severe disease appear to have increased frequency of cardiovascular (CV) diseases. The National Psoriasis Foundation recommends screening for CV risk factors as early as 20 years of age. The extent to which these screening guidelines are implemented in practice is unclear.

Objective: We sought to assess CV risk factor screening practices in patients with psoriasis and to assess primary care physician (PCP) and cardiologist awareness of worse CV outcomes in patients with psoriasis.

Methods: We distributed 1200 questionnaires to PCPs and cardiologists between October 1, 2010, and April 15, 2011. A representative national sample of physicians was obtained by random selection from professional medical societies.

Results: A total of 251 PCPs and cardiologists responded to the questionnaire. Among these physicians, 108 (43%) screened for hypertension, 27 (11%) screened for dyslipidemia, 75 (30%) screened for obesity, and 67 (27%) screened for diabetes. Physicians who cared for a greater number of patients with psoriasis were significantly more likely to screen for CV risk factors (hypertension P = .0041, dyslipidemia P = .0143, and diabetes P = .0065). Compared with PCPs, cardiologists were 3.5 times more likely to screen for dyslipidemia (95% confidence interval 1.32-9.29, P = .012). A total of 113 (45%) physicians were aware that psoriasis was associated with worse CV outcomes.

Limitations: The questionnaire response rate was modest.

Conclusions: Most PCPs and cardiologists did not routinely screen patients with psoriasis for CV risk factors. Educating physicians regarding potentially increased CV risk in psoriasis and adopting a multidisciplinary approach in the care of patients with psoriasis will likely lead to improved patient outcomes.