Cardiovascular risk factors and their evolution in a primary care psoriasis cohort: The REPICA study

OBJECTIVE: To determine the incidence and evolution of cardiovascular risk factors in patients with psoriasis managed in a primary care setting in Spain, and to explore the occurrence of cardiovascular events and mortality during follow-up. METHODS: Observational, longitudinal, multicenter, prospective study including patients ≥45 years with psoriasis attended in primary care in Spain. Participants were enrolled between May 2019 and May 2021 and followed annually. Incidence rates (per 1000 patients/year) of cardiovascular risk factors were estimated. Cardiovascular events and mortality were analyzed as exploratory outcomes. RESULTS: A total of 422 subjects were included (mean age 61.1 years; 51.4% male). At baseline, cardiovascular risk factors were highly prevalent (dyslipidemia 55%, hypertension 49%, diabetes 21%). Among patients with at least one follow-up visit (n=179; median follow-up 1.55 years), incidence rates per 1000 person-years were 49.05 for dyslipidemia, 30.48 for hypertension, 30.44 for obesity, and 14.90 for diabetes. Most patients showed stable psoriasis over time (∼80%). Exploratory analyses showed limited numbers of cardiovascular events and deaths, precluding robust inference. CONCLUSIONS: Patients with psoriasis managed in primary care present a high burden and incidence of cardiovascular risk factors, which may develop over a relatively short follow-up period. These findings support the importance of early detection and adequate management of cardiovascular risk in this population.