Association between pulse pressure and atherosclerosis in psoriatic arthritis patients

Background Psoriatic arthritis (PsA) is associated with an increased prevalence of cardiovascular events due to accelerated atherosclerosis that seems to depend on traditional and non-traditional risk factors(1). There is a positive correlation between pulse pressure (PP) and the progression of atherosclerosis in general population (2). Currently, there are no studies linking PP as an independent risk factor of atherosclerosis in PsA patients. Objectives To compare PP between PsA patients with and without carotid plaque (CP). Methods This was a cross-sectional study that included patients aged 40 to 75 years with PsA diagnosis according to the 2006 CASPAR criteria. A carotid ultrasound was performed in all patients, and they were divided into two groups, 27 patients with the presence of CP and 27 patients without CP matched by age, gender, and comorbidities. Blood pressure and PP was measured according to current guidelines. Distribution was evaluated with the Kolmogorov-Smirnov test. Comparisons were done with Chi-square test for qualitative variables and Student´s t test for quantitative variables. A p value <0.05 was considered statistically significant. Results There were no differences regarding demographic characteristics between groups. When comparing the arterial measures, a statistically significant difference was found in the PP, which was higher in patients with CP (48.66 ± 12.04 mmHg vs 41.51 ± 9.10 mmHg, p=0.017) (Table 1). A binary logistic regression was performed, and we found that PP was the only independent factor for the presence of CP in patients with PsA, OR 6.638 (95% CI 0.453- 12.823, p =0.036). Table 1. Demographic characteristics of the patients. Characteristics PsA patients with CP(n=27) PsA patients without CP(n=27) P Value Age, mean ± SD 51.55±8.24 50.74±8.68 NS Female gender, n (%) 16 (59.25) 15 (55.55) NS Obesity, n (%) 16 (59.25) 17 (62.96) NS T2DM, n (%) 20 (74.07) 23 (85.18) NS Hypertension, n (%) 19 (70.37) 22 (81.48) NS Dyslipidemia, n (%) 12 (44.44) 17 (62.96) NS Active smoking, n (%) 17 (62.96) 16 (59.25) NS Methotrexate, n (%) 9 (33.33) 11 (40.74) NS Glucocorticoid, n (%) 23 (85.18) 22 (81.48) NS bDMARD, n (%) 14 (51.85) 18 (66.66) NS SAP, mean ± SD 132.44±14.40 123.44±13.80 0.023 DAP, mean ± SD 83.77±10.71 81.92±10.95 NS PP, mean ± SD 48.66±12.04 41.51±9.10 0.017 PsA, psoriatic arthritis; NS, non-significant; T2DM, type 2 diabetes mellitus; bDMARD, biologic disease-modifying anti-rheumatic drugs; SAP, systolic arterial pressure; DAP, diastolic arterial pressure; PP, pulse pressure. Conclusion PsA patients with CP presented higher measures of PP compared with PsA patients without CP. This suggests that PP could be related with an increased risk of subclinical atherosclerosis in PsA patients. It is recommended to consider PP as an important parameter when evaluating cardiovascular risk in PsA patients. References [1]Ramonda R, Lo Nigro A, Modesti V, Nalotto L, Musacchio E, Iaccarino L, et al. Atherosclerosis in psoriatic arthritis. Autoimmun Rev [Internet]. 2011;10(12):773–8. Available from: http://dx.doi.org/10.1016/j.autrev.2011.05.022 [2]Amar J, Chamontin B. Cardiovascular risk factors, atherosclerosis and pulse pressure. Adv Cardiol. 2007;44:212–22. Disclosure of Interests None declared