Research ArticleArticle
Gaps in Diagnosis and Treatment of Cardiovascular Risk Factors in Patients with Psoriatic Disease: An International Multicenter Study
Lihi Eder, Paula Harvey, Vinod Chandran, Cheryl F. Rosen, Jan Dutz, James T. Elder, Proton Rahman, Christopher T. Ritchlin, Sherry Rohekar, Richard Hayday, Snezana Barac, Joy Feld, Devy Zisman and Dafna D. Gladman
The Journal of Rheumatology February 2018, jrheum.170379; DOI: https://doi.org/10.3899/jrheum.170379
Lihi Eder
From the Women’s College Research Institute, Women’s College Hospital; Department of Medicine, University of Toronto; Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital; Division of Dermatology, University of Toronto, Toronto Western Hospital, Toronto; Western University, London, Ontario; University of British Columbia, Vancouver, British Columbia; Memorial University of Newfoundland, St. John’s, Newfoundland; University of Manitoba; Winnipeg Clinic, Winnipeg, Manitoba, Canada; University of Michigan Medical School, Ann Arbor, Michigan; Allergy, Immunology and Rheumatology Division, University of Rochester Medical Center, Rochester, New York, USA; Rheumatology Unit, Carmel Medical Center, Haifa, Israel. L. Eder, MD, PhD, Women’s College Research Institute, Women’s College Hospital, and Department of Medicine, University of Toronto; P. Harvey, BMBS, PhD, Women’s College Research Institute, Women’s College Hospital, and Department of Medicine, University of Toronto; V. Chandran, MD, DM, PhD, Department of Medicine, University of Toronto, and Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital; C.F. Rosen, MD, FRCPC, Department of Medicine, University of Toronto, and Division of Dermatology, University of Toronto, Toronto Western Hospital; J. Dutz, MD, FRCPC, University of British Columbia; J.T. Elder, MD, PhD, University of Michigan Medical School; P. Rahman, MD, MSc, FRCPC, Memorial University of Newfoundland; C.T. Ritchlin, MD, MPH, Allergy, Immunology and Rheumatology Division, University of Rochester Medical Center; S. Rohekar, MD, FRCPC, Western University; R. Hayday, MD, FRCPC, University of Manitoba; S. Barac, MD, FRCPC, Winnipeg Clinic; J. Feld, MD, Rheumatology Unit, Carmel Medical Center; D. Zisman, MD, Rheumatology Unit, Carmel Medical Center; D.D. Gladman, MD, FRCPC, Department of Medicine, University of Toronto, and Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital. Address correspondence to Dr. L. Eder, Women’s College Research Institute, Women’s College Hospital, 76 Grenville St., Toronto, Ontario M5S 1B2, Canada. E-mail: lihi.eder@wchospital.ca. Accepted for publication October 11, 2017.
Paula Harvey
From the Women’s College Research Institute, Women’s College Hospital; Department of Medicine, University of Toronto; Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital; Division of Dermatology, University of Toronto, Toronto Western Hospital, Toronto; Western University, London, Ontario; University of British Columbia, Vancouver, British Columbia; Memorial University of Newfoundland, St. John’s, Newfoundland; University of Manitoba; Winnipeg Clinic, Winnipeg, Manitoba, Canada; University of Michigan Medical School, Ann Arbor, Michigan; Allergy, Immunology and Rheumatology Division, University of Rochester Medical Center, Rochester, New York, USA; Rheumatology Unit, Carmel Medical Center, Haifa, Israel. L. Eder, MD, PhD, Women’s College Research Institute, Women’s College Hospital, and Department of Medicine, University of Toronto; P. Harvey, BMBS, PhD, Women’s College Research Institute, Women’s College Hospital, and Department of Medicine, University of Toronto; V. Chandran, MD, DM, PhD, Department of Medicine, University of Toronto, and Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital; C.F. Rosen, MD, FRCPC, Department of Medicine, University of Toronto, and Division of Dermatology, University of Toronto, Toronto Western Hospital; J. Dutz, MD, FRCPC, University of British Columbia; J.T. Elder, MD, PhD, University of Michigan Medical School; P. Rahman, MD, MSc, FRCPC, Memorial University of Newfoundland; C.T. Ritchlin, MD, MPH, Allergy, Immunology and Rheumatology Division, University of Rochester Medical Center; S. Rohekar, MD, FRCPC, Western University; R. Hayday, MD, FRCPC, University of Manitoba; S. Barac, MD, FRCPC, Winnipeg Clinic; J. Feld, MD, Rheumatology Unit, Carmel Medical Center; D. Zisman, MD, Rheumatology Unit, Carmel Medical Center; D.D. Gladman, MD, FRCPC, Department of Medicine, University of Toronto, and Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital. Address correspondence to Dr. L. Eder, Women’s College Research Institute, Women’s College Hospital, 76 Grenville St., Toronto, Ontario M5S 1B2, Canada. E-mail: lihi.eder@wchospital.ca. Accepted for publication October 11, 2017.
Vinod Chandran
From the Women’s College Research Institute, Women’s College Hospital; Department of Medicine, University of Toronto; Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital; Division of Dermatology, University of Toronto, Toronto Western Hospital, Toronto; Western University, London, Ontario; University of British Columbia, Vancouver, British Columbia; Memorial University of Newfoundland, St. John’s, Newfoundland; University of Manitoba; Winnipeg Clinic, Winnipeg, Manitoba, Canada; University of Michigan Medical School, Ann Arbor, Michigan; Allergy, Immunology and Rheumatology Division, University of Rochester Medical Center, Rochester, New York, USA; Rheumatology Unit, Carmel Medical Center, Haifa, Israel. L. Eder, MD, PhD, Women’s College Research Institute, Women’s College Hospital, and Department of Medicine, University of Toronto; P. Harvey, BMBS, PhD, Women’s College Research Institute, Women’s College Hospital, and Department of Medicine, University of Toronto; V. Chandran, MD, DM, PhD, Department of Medicine, University of Toronto, and Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital; C.F. Rosen, MD, FRCPC, Department of Medicine, University of Toronto, and Division of Dermatology, University of Toronto, Toronto Western Hospital; J. Dutz, MD, FRCPC, University of British Columbia; J.T. Elder, MD, PhD, University of Michigan Medical School; P. Rahman, MD, MSc, FRCPC, Memorial University of Newfoundland; C.T. Ritchlin, MD, MPH, Allergy, Immunology and Rheumatology Division, University of Rochester Medical Center; S. Rohekar, MD, FRCPC, Western University; R. Hayday, MD, FRCPC, University of Manitoba; S. Barac, MD, FRCPC, Winnipeg Clinic; J. Feld, MD, Rheumatology Unit, Carmel Medical Center; D. Zisman, MD, Rheumatology Unit, Carmel Medical Center; D.D. Gladman, MD, FRCPC, Department of Medicine, University of Toronto, and Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital. Address correspondence to Dr. L. Eder, Women’s College Research Institute, Women’s College Hospital, 76 Grenville St., Toronto, Ontario M5S 1B2, Canada. E-mail: lihi.eder@wchospital.ca. Accepted for publication October 11, 2017.
Cheryl F. Rosen
From the Women’s College Research Institute, Women’s College Hospital; Department of Medicine, University of Toronto; Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital; Division of Dermatology, University of Toronto, Toronto Western Hospital, Toronto; Western University, London, Ontario; University of British Columbia, Vancouver, British Columbia; Memorial University of Newfoundland, St. John’s, Newfoundland; University of Manitoba; Winnipeg Clinic, Winnipeg, Manitoba, Canada; University of Michigan Medical School, Ann Arbor, Michigan; Allergy, Immunology and Rheumatology Division, University of Rochester Medical Center, Rochester, New York, USA; Rheumatology Unit, Carmel Medical Center, Haifa, Israel. L. Eder, MD, PhD, Women’s College Research Institute, Women’s College Hospital, and Department of Medicine, University of Toronto; P. Harvey, BMBS, PhD, Women’s College Research Institute, Women’s College Hospital, and Department of Medicine, University of Toronto; V. Chandran, MD, DM, PhD, Department of Medicine, University of Toronto, and Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital; C.F. Rosen, MD, FRCPC, Department of Medicine, University of Toronto, and Division of Dermatology, University of Toronto, Toronto Western Hospital; J. Dutz, MD, FRCPC, University of British Columbia; J.T. Elder, MD, PhD, University of Michigan Medical School; P. Rahman, MD, MSc, FRCPC, Memorial University of Newfoundland; C.T. Ritchlin, MD, MPH, Allergy, Immunology and Rheumatology Division, University of Rochester Medical Center; S. Rohekar, MD, FRCPC, Western University; R. Hayday, MD, FRCPC, University of Manitoba; S. Barac, MD, FRCPC, Winnipeg Clinic; J. Feld, MD, Rheumatology Unit, Carmel Medical Center; D. Zisman, MD, Rheumatology Unit, Carmel Medical Center; D.D. Gladman, MD, FRCPC, Department of Medicine, University of Toronto, and Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital. Address correspondence to Dr. L. Eder, Women’s College Research Institute, Women’s College Hospital, 76 Grenville St., Toronto, Ontario M5S 1B2, Canada. E-mail: lihi.eder@wchospital.ca. Accepted for publication October 11, 2017.
Jan Dutz
From the Women’s College Research Institute, Women’s College Hospital; Department of Medicine, University of Toronto; Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital; Division of Dermatology, University of Toronto, Toronto Western Hospital, Toronto; Western University, London, Ontario; University of British Columbia, Vancouver, British Columbia; Memorial University of Newfoundland, St. John’s, Newfoundland; University of Manitoba; Winnipeg Clinic, Winnipeg, Manitoba, Canada; University of Michigan Medical School, Ann Arbor, Michigan; Allergy, Immunology and Rheumatology Division, University of Rochester Medical Center, Rochester, New York, USA; Rheumatology Unit, Carmel Medical Center, Haifa, Israel. L. Eder, MD, PhD, Women’s College Research Institute, Women’s College Hospital, and Department of Medicine, University of Toronto; P. Harvey, BMBS, PhD, Women’s College Research Institute, Women’s College Hospital, and Department of Medicine, University of Toronto; V. Chandran, MD, DM, PhD, Department of Medicine, University of Toronto, and Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital; C.F. Rosen, MD, FRCPC, Department of Medicine, University of Toronto, and Division of Dermatology, University of Toronto, Toronto Western Hospital; J. Dutz, MD, FRCPC, University of British Columbia; J.T. Elder, MD, PhD, University of Michigan Medical School; P. Rahman, MD, MSc, FRCPC, Memorial University of Newfoundland; C.T. Ritchlin, MD, MPH, Allergy, Immunology and Rheumatology Division, University of Rochester Medical Center; S. Rohekar, MD, FRCPC, Western University; R. Hayday, MD, FRCPC, University of Manitoba; S. Barac, MD, FRCPC, Winnipeg Clinic; J. Feld, MD, Rheumatology Unit, Carmel Medical Center; D. Zisman, MD, Rheumatology Unit, Carmel Medical Center; D.D. Gladman, MD, FRCPC, Department of Medicine, University of Toronto, and Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital. Address correspondence to Dr. L. Eder, Women’s College Research Institute, Women’s College Hospital, 76 Grenville St., Toronto, Ontario M5S 1B2, Canada. E-mail: lihi.eder@wchospital.ca. Accepted for publication October 11, 2017.
James T. Elder
From the Women’s College Research Institute, Women’s College Hospital; Department of Medicine, University of Toronto; Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital; Division of Dermatology, University of Toronto, Toronto Western Hospital, Toronto; Western University, London, Ontario; University of British Columbia, Vancouver, British Columbia; Memorial University of Newfoundland, St. John’s, Newfoundland; University of Manitoba; Winnipeg Clinic, Winnipeg, Manitoba, Canada; University of Michigan Medical School, Ann Arbor, Michigan; Allergy, Immunology and Rheumatology Division, University of Rochester Medical Center, Rochester, New York, USA; Rheumatology Unit, Carmel Medical Center, Haifa, Israel. L. Eder, MD, PhD, Women’s College Research Institute, Women’s College Hospital, and Department of Medicine, University of Toronto; P. Harvey, BMBS, PhD, Women’s College Research Institute, Women’s College Hospital, and Department of Medicine, University of Toronto; V. Chandran, MD, DM, PhD, Department of Medicine, University of Toronto, and Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital; C.F. Rosen, MD, FRCPC, Department of Medicine, University of Toronto, and Division of Dermatology, University of Toronto, Toronto Western Hospital; J. Dutz, MD, FRCPC, University of British Columbia; J.T. Elder, MD, PhD, University of Michigan Medical School; P. Rahman, MD, MSc, FRCPC, Memorial University of Newfoundland; C.T. Ritchlin, MD, MPH, Allergy, Immunology and Rheumatology Division, University of Rochester Medical Center; S. Rohekar, MD, FRCPC, Western University; R. Hayday, MD, FRCPC, University of Manitoba; S. Barac, MD, FRCPC, Winnipeg Clinic; J. Feld, MD, Rheumatology Unit, Carmel Medical Center; D. Zisman, MD, Rheumatology Unit, Carmel Medical Center; D.D. Gladman, MD, FRCPC, Department of Medicine, University of Toronto, and Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital. Address correspondence to Dr. L. Eder, Women’s College Research Institute, Women’s College Hospital, 76 Grenville St., Toronto, Ontario M5S 1B2, Canada. E-mail: lihi.eder@wchospital.ca. Accepted for publication October 11, 2017.
Proton Rahman
From the Women’s College Research Institute, Women’s College Hospital; Department of Medicine, University of Toronto; Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital; Division of Dermatology, University of Toronto, Toronto Western Hospital, Toronto; Western University, London, Ontario; University of British Columbia, Vancouver, British Columbia; Memorial University of Newfoundland, St. John’s, Newfoundland; University of Manitoba; Winnipeg Clinic, Winnipeg, Manitoba, Canada; University of Michigan Medical School, Ann Arbor, Michigan; Allergy, Immunology and Rheumatology Division, University of Rochester Medical Center, Rochester, New York, USA; Rheumatology Unit, Carmel Medical Center, Haifa, Israel. L. Eder, MD, PhD, Women’s College Research Institute, Women’s College Hospital, and Department of Medicine, University of Toronto; P. Harvey, BMBS, PhD, Women’s College Research Institute, Women’s College Hospital, and Department of Medicine, University of Toronto; V. Chandran, MD, DM, PhD, Department of Medicine, University of Toronto, and Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital; C.F. Rosen, MD, FRCPC, Department of Medicine, University of Toronto, and Division of Dermatology, University of Toronto, Toronto Western Hospital; J. Dutz, MD, FRCPC, University of British Columbia; J.T. Elder, MD, PhD, University of Michigan Medical School; P. Rahman, MD, MSc, FRCPC, Memorial University of Newfoundland; C.T. Ritchlin, MD, MPH, Allergy, Immunology and Rheumatology Division, University of Rochester Medical Center; S. Rohekar, MD, FRCPC, Western University; R. Hayday, MD, FRCPC, University of Manitoba; S. Barac, MD, FRCPC, Winnipeg Clinic; J. Feld, MD, Rheumatology Unit, Carmel Medical Center; D. Zisman, MD, Rheumatology Unit, Carmel Medical Center; D.D. Gladman, MD, FRCPC, Department of Medicine, University of Toronto, and Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital. Address correspondence to Dr. L. Eder, Women’s College Research Institute, Women’s College Hospital, 76 Grenville St., Toronto, Ontario M5S 1B2, Canada. E-mail: lihi.eder@wchospital.ca. Accepted for publication October 11, 2017.
Christopher T. Ritchlin
From the Women’s College Research Institute, Women’s College Hospital; Department of Medicine, University of Toronto; Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital; Division of Dermatology, University of Toronto, Toronto Western Hospital, Toronto; Western University, London, Ontario; University of British Columbia, Vancouver, British Columbia; Memorial University of Newfoundland, St. John’s, Newfoundland; University of Manitoba; Winnipeg Clinic, Winnipeg, Manitoba, Canada; University of Michigan Medical School, Ann Arbor, Michigan; Allergy, Immunology and Rheumatology Division, University of Rochester Medical Center, Rochester, New York, USA; Rheumatology Unit, Carmel Medical Center, Haifa, Israel. L. Eder, MD, PhD, Women’s College Research Institute, Women’s College Hospital, and Department of Medicine, University of Toronto; P. Harvey, BMBS, PhD, Women’s College Research Institute, Women’s College Hospital, and Department of Medicine, University of Toronto; V. Chandran, MD, DM, PhD, Department of Medicine, University of Toronto, and Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital; C.F. Rosen, MD, FRCPC, Department of Medicine, University of Toronto, and Division of Dermatology, University of Toronto, Toronto Western Hospital; J. Dutz, MD, FRCPC, University of British Columbia; J.T. Elder, MD, PhD, University of Michigan Medical School; P. Rahman, MD, MSc, FRCPC, Memorial University of Newfoundland; C.T. Ritchlin, MD, MPH, Allergy, Immunology and Rheumatology Division, University of Rochester Medical Center; S. Rohekar, MD, FRCPC, Western University; R. Hayday, MD, FRCPC, University of Manitoba; S. Barac, MD, FRCPC, Winnipeg Clinic; J. Feld, MD, Rheumatology Unit, Carmel Medical Center; D. Zisman, MD, Rheumatology Unit, Carmel Medical Center; D.D. Gladman, MD, FRCPC, Department of Medicine, University of Toronto, and Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital. Address correspondence to Dr. L. Eder, Women’s College Research Institute, Women’s College Hospital, 76 Grenville St., Toronto, Ontario M5S 1B2, Canada. E-mail: lihi.eder@wchospital.ca. Accepted for publication October 11, 2017.
Sherry Rohekar
From the Women’s College Research Institute, Women’s College Hospital; Department of Medicine, University of Toronto; Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital; Division of Dermatology, University of Toronto, Toronto Western Hospital, Toronto; Western University, London, Ontario; University of British Columbia, Vancouver, British Columbia; Memorial University of Newfoundland, St. John’s, Newfoundland; University of Manitoba; Winnipeg Clinic, Winnipeg, Manitoba, Canada; University of Michigan Medical School, Ann Arbor, Michigan; Allergy, Immunology and Rheumatology Division, University of Rochester Medical Center, Rochester, New York, USA; Rheumatology Unit, Carmel Medical Center, Haifa, Israel. L. Eder, MD, PhD, Women’s College Research Institute, Women’s College Hospital, and Department of Medicine, University of Toronto; P. Harvey, BMBS, PhD, Women’s College Research Institute, Women’s College Hospital, and Department of Medicine, University of Toronto; V. Chandran, MD, DM, PhD, Department of Medicine, University of Toronto, and Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital; C.F. Rosen, MD, FRCPC, Department of Medicine, University of Toronto, and Division of Dermatology, University of Toronto, Toronto Western Hospital; J. Dutz, MD, FRCPC, University of British Columbia; J.T. Elder, MD, PhD, University of Michigan Medical School; P. Rahman, MD, MSc, FRCPC, Memorial University of Newfoundland; C.T. Ritchlin, MD, MPH, Allergy, Immunology and Rheumatology Division, University of Rochester Medical Center; S. Rohekar, MD, FRCPC, Western University; R. Hayday, MD, FRCPC, University of Manitoba; S. Barac, MD, FRCPC, Winnipeg Clinic; J. Feld, MD, Rheumatology Unit, Carmel Medical Center; D. Zisman, MD, Rheumatology Unit, Carmel Medical Center; D.D. Gladman, MD, FRCPC, Department of Medicine, University of Toronto, and Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital. Address correspondence to Dr. L. Eder, Women’s College Research Institute, Women’s College Hospital, 76 Grenville St., Toronto, Ontario M5S 1B2, Canada. E-mail: lihi.eder@wchospital.ca. Accepted for publication October 11, 2017.
Richard Hayday
From the Women’s College Research Institute, Women’s College Hospital; Department of Medicine, University of Toronto; Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital; Division of Dermatology, University of Toronto, Toronto Western Hospital, Toronto; Western University, London, Ontario; University of British Columbia, Vancouver, British Columbia; Memorial University of Newfoundland, St. John’s, Newfoundland; University of Manitoba; Winnipeg Clinic, Winnipeg, Manitoba, Canada; University of Michigan Medical School, Ann Arbor, Michigan; Allergy, Immunology and Rheumatology Division, University of Rochester Medical Center, Rochester, New York, USA; Rheumatology Unit, Carmel Medical Center, Haifa, Israel. L. Eder, MD, PhD, Women’s College Research Institute, Women’s College Hospital, and Department of Medicine, University of Toronto; P. Harvey, BMBS, PhD, Women’s College Research Institute, Women’s College Hospital, and Department of Medicine, University of Toronto; V. Chandran, MD, DM, PhD, Department of Medicine, University of Toronto, and Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital; C.F. Rosen, MD, FRCPC, Department of Medicine, University of Toronto, and Division of Dermatology, University of Toronto, Toronto Western Hospital; J. Dutz, MD, FRCPC, University of British Columbia; J.T. Elder, MD, PhD, University of Michigan Medical School; P. Rahman, MD, MSc, FRCPC, Memorial University of Newfoundland; C.T. Ritchlin, MD, MPH, Allergy, Immunology and Rheumatology Division, University of Rochester Medical Center; S. Rohekar, MD, FRCPC, Western University; R. Hayday, MD, FRCPC, University of Manitoba; S. Barac, MD, FRCPC, Winnipeg Clinic; J. Feld, MD, Rheumatology Unit, Carmel Medical Center; D. Zisman, MD, Rheumatology Unit, Carmel Medical Center; D.D. Gladman, MD, FRCPC, Department of Medicine, University of Toronto, and Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital. Address correspondence to Dr. L. Eder, Women’s College Research Institute, Women’s College Hospital, 76 Grenville St., Toronto, Ontario M5S 1B2, Canada. E-mail: lihi.eder@wchospital.ca. Accepted for publication October 11, 2017.
Snezana Barac
From the Women’s College Research Institute, Women’s College Hospital; Department of Medicine, University of Toronto; Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital; Division of Dermatology, University of Toronto, Toronto Western Hospital, Toronto; Western University, London, Ontario; University of British Columbia, Vancouver, British Columbia; Memorial University of Newfoundland, St. John’s, Newfoundland; University of Manitoba; Winnipeg Clinic, Winnipeg, Manitoba, Canada; University of Michigan Medical School, Ann Arbor, Michigan; Allergy, Immunology and Rheumatology Division, University of Rochester Medical Center, Rochester, New York, USA; Rheumatology Unit, Carmel Medical Center, Haifa, Israel. L. Eder, MD, PhD, Women’s College Research Institute, Women’s College Hospital, and Department of Medicine, University of Toronto; P. Harvey, BMBS, PhD, Women’s College Research Institute, Women’s College Hospital, and Department of Medicine, University of Toronto; V. Chandran, MD, DM, PhD, Department of Medicine, University of Toronto, and Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital; C.F. Rosen, MD, FRCPC, Department of Medicine, University of Toronto, and Division of Dermatology, University of Toronto, Toronto Western Hospital; J. Dutz, MD, FRCPC, University of British Columbia; J.T. Elder, MD, PhD, University of Michigan Medical School; P. Rahman, MD, MSc, FRCPC, Memorial University of Newfoundland; C.T. Ritchlin, MD, MPH, Allergy, Immunology and Rheumatology Division, University of Rochester Medical Center; S. Rohekar, MD, FRCPC, Western University; R. Hayday, MD, FRCPC, University of Manitoba; S. Barac, MD, FRCPC, Winnipeg Clinic; J. Feld, MD, Rheumatology Unit, Carmel Medical Center; D. Zisman, MD, Rheumatology Unit, Carmel Medical Center; D.D. Gladman, MD, FRCPC, Department of Medicine, University of Toronto, and Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital. Address correspondence to Dr. L. Eder, Women’s College Research Institute, Women’s College Hospital, 76 Grenville St., Toronto, Ontario M5S 1B2, Canada. E-mail: lihi.eder@wchospital.ca. Accepted for publication October 11, 2017.
Joy Feld
From the Women’s College Research Institute, Women’s College Hospital; Department of Medicine, University of Toronto; Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital; Division of Dermatology, University of Toronto, Toronto Western Hospital, Toronto; Western University, London, Ontario; University of British Columbia, Vancouver, British Columbia; Memorial University of Newfoundland, St. John’s, Newfoundland; University of Manitoba; Winnipeg Clinic, Winnipeg, Manitoba, Canada; University of Michigan Medical School, Ann Arbor, Michigan; Allergy, Immunology and Rheumatology Division, University of Rochester Medical Center, Rochester, New York, USA; Rheumatology Unit, Carmel Medical Center, Haifa, Israel. L. Eder, MD, PhD, Women’s College Research Institute, Women’s College Hospital, and Department of Medicine, University of Toronto; P. Harvey, BMBS, PhD, Women’s College Research Institute, Women’s College Hospital, and Department of Medicine, University of Toronto; V. Chandran, MD, DM, PhD, Department of Medicine, University of Toronto, and Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital; C.F. Rosen, MD, FRCPC, Department of Medicine, University of Toronto, and Division of Dermatology, University of Toronto, Toronto Western Hospital; J. Dutz, MD, FRCPC, University of British Columbia; J.T. Elder, MD, PhD, University of Michigan Medical School; P. Rahman, MD, MSc, FRCPC, Memorial University of Newfoundland; C.T. Ritchlin, MD, MPH, Allergy, Immunology and Rheumatology Division, University of Rochester Medical Center; S. Rohekar, MD, FRCPC, Western University; R. Hayday, MD, FRCPC, University of Manitoba; S. Barac, MD, FRCPC, Winnipeg Clinic; J. Feld, MD, Rheumatology Unit, Carmel Medical Center; D. Zisman, MD, Rheumatology Unit, Carmel Medical Center; D.D. Gladman, MD, FRCPC, Department of Medicine, University of Toronto, and Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital. Address correspondence to Dr. L. Eder, Women’s College Research Institute, Women’s College Hospital, 76 Grenville St., Toronto, Ontario M5S 1B2, Canada. E-mail: lihi.eder@wchospital.ca. Accepted for publication October 11, 2017.
Devy Zisman
From the Women’s College Research Institute, Women’s College Hospital; Department of Medicine, University of Toronto; Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital; Division of Dermatology, University of Toronto, Toronto Western Hospital, Toronto; Western University, London, Ontario; University of British Columbia, Vancouver, British Columbia; Memorial University of Newfoundland, St. John’s, Newfoundland; University of Manitoba; Winnipeg Clinic, Winnipeg, Manitoba, Canada; University of Michigan Medical School, Ann Arbor, Michigan; Allergy, Immunology and Rheumatology Division, University of Rochester Medical Center, Rochester, New York, USA; Rheumatology Unit, Carmel Medical Center, Haifa, Israel. L. Eder, MD, PhD, Women’s College Research Institute, Women’s College Hospital, and Department of Medicine, University of Toronto; P. Harvey, BMBS, PhD, Women’s College Research Institute, Women’s College Hospital, and Department of Medicine, University of Toronto; V. Chandran, MD, DM, PhD, Department of Medicine, University of Toronto, and Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital; C.F. Rosen, MD, FRCPC, Department of Medicine, University of Toronto, and Division of Dermatology, University of Toronto, Toronto Western Hospital; J. Dutz, MD, FRCPC, University of British Columbia; J.T. Elder, MD, PhD, University of Michigan Medical School; P. Rahman, MD, MSc, FRCPC, Memorial University of Newfoundland; C.T. Ritchlin, MD, MPH, Allergy, Immunology and Rheumatology Division, University of Rochester Medical Center; S. Rohekar, MD, FRCPC, Western University; R. Hayday, MD, FRCPC, University of Manitoba; S. Barac, MD, FRCPC, Winnipeg Clinic; J. Feld, MD, Rheumatology Unit, Carmel Medical Center; D. Zisman, MD, Rheumatology Unit, Carmel Medical Center; D.D. Gladman, MD, FRCPC, Department of Medicine, University of Toronto, and Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital. Address correspondence to Dr. L. Eder, Women’s College Research Institute, Women’s College Hospital, 76 Grenville St., Toronto, Ontario M5S 1B2, Canada. E-mail: lihi.eder@wchospital.ca. Accepted for publication October 11, 2017.
Dafna D. Gladman
From the Women’s College Research Institute, Women’s College Hospital; Department of Medicine, University of Toronto; Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital; Division of Dermatology, University of Toronto, Toronto Western Hospital, Toronto; Western University, London, Ontario; University of British Columbia, Vancouver, British Columbia; Memorial University of Newfoundland, St. John’s, Newfoundland; University of Manitoba; Winnipeg Clinic, Winnipeg, Manitoba, Canada; University of Michigan Medical School, Ann Arbor, Michigan; Allergy, Immunology and Rheumatology Division, University of Rochester Medical Center, Rochester, New York, USA; Rheumatology Unit, Carmel Medical Center, Haifa, Israel. L. Eder, MD, PhD, Women’s College Research Institute, Women’s College Hospital, and Department of Medicine, University of Toronto; P. Harvey, BMBS, PhD, Women’s College Research Institute, Women’s College Hospital, and Department of Medicine, University of Toronto; V. Chandran, MD, DM, PhD, Department of Medicine, University of Toronto, and Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital; C.F. Rosen, MD, FRCPC, Department of Medicine, University of Toronto, and Division of Dermatology, University of Toronto, Toronto Western Hospital; J. Dutz, MD, FRCPC, University of British Columbia; J.T. Elder, MD, PhD, University of Michigan Medical School; P. Rahman, MD, MSc, FRCPC, Memorial University of Newfoundland; C.T. Ritchlin, MD, MPH, Allergy, Immunology and Rheumatology Division, University of Rochester Medical Center; S. Rohekar, MD, FRCPC, Western University; R. Hayday, MD, FRCPC, University of Manitoba; S. Barac, MD, FRCPC, Winnipeg Clinic; J. Feld, MD, Rheumatology Unit, Carmel Medical Center; D. Zisman, MD, Rheumatology Unit, Carmel Medical Center; D.D. Gladman, MD, FRCPC, Department of Medicine, University of Toronto, and Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital. Address correspondence to Dr. L. Eder, Women’s College Research Institute, Women’s College Hospital, 76 Grenville St., Toronto, Ontario M5S 1B2, Canada. E-mail: lihi.eder@wchospital.ca. Accepted for publication October 11, 2017.
Abstract
Objective We aimed to estimate the proportion of underdiagnosis and undertreatment of cardiovascular risk factors (CVRF) in an international multicenter cohort of patients with psoriasis and psoriatic arthritis (PsA).
Methods A cross-sectional analysis was conducted of patients with psoriatic disease from the International Psoriasis and Arthritis Research Team cohort. The presence of modifiable CVRF [diabetes, hypertension (HTN), dyslipidemia, smoking, elevated body mass index, and central obesity] and the use of appropriate therapies for HTN and dyslipidemia were determined. The 10-year CV risk was calculated according to the Framingham Risk Score. Physician adherence with guidelines for the treatment of dyslipidemia and HTN was assessed. Regression analysis was used to assess predictors of undertreatment of HTN and dyslipidemia.
Results A total of 2254 patients (58.9% PsA, 41.1% psoriasis) from 8 centers in Canada, the United States, and Israel were included. Their mean age was 52 ± 13.8 years and 53% were men. Of the patients, 87.6% had at least 1 modifiable CVRF, 45.1% had HTN, 49.4% dyslipidemia, 13.3% diabetes, 75.3% were overweight or obese, 54.3% central obesity, and 17.3% were current smokers. We found 59.2% of patients with HTN and 65.6% of patients with dyslipidemia were undertreated. Undertreatment was associated with younger age (≤ 50 yrs), having psoriasis, and male sex.
Conclusion In real-world settings, a large proportion of patients with psoriasis and PsA were underdiagnosed and undertreated for HTN and dyslipidemia. Strategies to improve the management of CVRF in psoriatic patients are warranted.
In this issue
The Journal of Rheumatology
Vol. 49, Issue 8
1 Aug 2022
Gaps in Diagnosis and Treatment of Cardiovascular Risk Factors in Patients with Psoriatic Disease: An International Multicenter Study
Lihi Eder, Paula Harvey, Vinod Chandran, Cheryl F. Rosen, Jan Dutz, James T. Elder, Proton Rahman, Christopher T. Ritchlin, Sherry Rohekar, Richard Hayday, Snezana Barac, Joy Feld, Devy Zisman, Dafna D. Gladman
The Journal of Rheumatology Feb 2018, jrheum.170379; DOI: 10.3899/jrheum.170379
Gaps in Diagnosis and Treatment of Cardiovascular Risk Factors in Patients with Psoriatic Disease: An International Multicenter Study
Lihi Eder, Paula Harvey, Vinod Chandran, Cheryl F. Rosen, Jan Dutz, James T. Elder, Proton Rahman, Christopher T. Ritchlin, Sherry Rohekar, Richard Hayday, Snezana Barac, Joy Feld, Devy Zisman, Dafna D. Gladman
The Journal of Rheumatology Feb 2018, jrheum.170379; DOI: 10.3899/jrheum.170379
