Is There a Link Between Severe Atopic Eczema and Cardiovascular Disease?
Atopic eczema is a common relapsing condition the affects up to 10% of adults. Because of its systemic inflammatory component, it is thought that atopic eczema may contribute to cardiovascular outcomes, but it is not known whether the cardiovascular risks may correlate with the severity of disease. A recent study explored whether adults with atopic eczema are at a greater risk of cardiovascular events and how the risk of cardiovascular disease (CVD) varied by atopic eczema severity and eczema activity over time.
The large cohort study examined a database of records for adult patients with an atopic eczema diagnosis and two atopic eczema treatments, compared with a matched cohort of unexposed patients. The severity of disease for exposed patients was classified into three categories: mild, moderate, or severe. Once classified into a category the patient remained in that category despite the changeable nature of AD. Researchers looked for recorded cardiovascular events including: myocardial infarction, unstable angina, heart failure, atrial fibrillation, stroke (ischemic, hemorrhagic, or unspecified), and cardiovascular death. The final sample included 387,439 exposed patients and 1,528,477 unexposed patients. The median follow-up was 5.1 years and during that period 5% of patients experienced severe atopic eczema.
The results showed that atopic eczema is associated with a moderately increased risk of non-fatal cardiovascular outcomes. Additionally, there is a dose-response for atopic eczema severity and cumulated activity as patients with severe atopic eczema were at increased risk of for stroke, unstable angina, myocardial infarction, atrial fibrillation, cardiovascular death, and 70% increased risk of heart failure.
The authors conclude that providers should give greater consideration for CVD screening among patients with severe or predominantly active atopic eczema.