Eczema and increased risk of cardiovascular disease

03 Aug 2018

Adults with eczema could face an increased risk of experiencing non-fatal cardiovascular disease, according to a recent study carried out by members of the Electronic Health Records Research Group at LSHTM.

The observational study involving almost 2 million people found that patients with eczema were 10-20% more likely to experience non-fatal cardiovascular disease than people without eczema, and that the risk increased with more severe disease. Using UK electronic health records from the Clinical Practice Research Datalink, Hospital Episode Statistics and data from the Office for National Statistics between 1998–2015, patients diagnosed with eczema were matched to those without on age, gender, general practice and calendar time. After adjusting for confounders such as socioeconomic status and age, the differences in cardiovascular disease risk between the two groups was analysed. Risk in severe eczema persisted even after adjusting for traditional cardiovascular risk factors that might mediate this association, including smoking and body mass index.

Patients with severe eczema were found to experience a 20% increased risk of stroke, 70% increased risk of heart failure, and 40–50% increased risk of the remaining cardiovascular outcomes, including unstable angina, myocardial infarction, atrial fibrillation and cardiovascular death. Eczema can vary over time and patients whose eczema was active for most of their follow up were also at greater risk of cardiovascular outcomes. The risk was mainly confined to patients with severe eczema, including people on oral immunosuppressive drugs, receiving phototherapy treatment for eczema or who were referred to dermatologists.

Eczema, also known as atopic eczema or atopic dermatitis, is a common systemic inflammatory condition which affects up to 10% of adults and is becoming more common globally. Symptoms include intense itch, pain and sleeplessness. It’s estimated that around 30% of eczema patients would be classified as having moderate-severe eczema.

Dr Sinead Langan said: “Eczema is a debilitating common condition. Increasing evidence suggests that severe eczema could be associated with a wider range of health problems than originally thought. Previous studies on the link between eczema and cardiovascular disease have reported mixed findings. However, these have lacked data on specific risk factors and have not assessed levels of eczema activity over time, points which our research addressed.”

The absolute risk of people with eczema experiencing a cardiovascular event is low. However, the links uncovered in this research, if robustly replicated by future studies, would support targeted screening and focus on primary prevention strategies to reduce cardiovascular disease among patients with eczema.

The full article was published in the British Medical Journal.