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Adults with severe eczema ‘should be screened for cardiovascular risk’

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Severe eczema in adults is linked to an increased risk of cardiovascular problems including heart attack and stroke, according to a major new study involving UK researchers.

The team behind the work said their findings could support the case for targeted screening for heart problems among people with atopic eczema, which affects up to 10% of the adult population.

“Severe and predominantly active atopic eczema are associated with an increased risk of cardiovascular outcomes”

Study authors

The study, led by the London School of Hygiene and Tropical Medicine, comes amid mounting evidence that people with severe chronic inflammatory diseases like rheumatoid arthritis and severe psoriasis may be at greater risk of cardiovascular disease.

However, previous studies exploring the link between atopic eczema and heart problems have obtained mixed results.

This latest study, said to be the largest to date, saw an international team match nearly 400,000 people with atopic eczema with more than 1.5 million people of similar age and sex but without eczema.

Patients were classed as having mild, moderate or severe eczema and were followed for an average of five years.

Over the period, major cardiovascular events were recorded including heart attacks, heart failure, unstable angina, irregular heartbeat, stroke and “cardiovascular death”.

After taking into account known cardiovascular risk factors, such as weight, smoking and alcohol intake, the researchers found people with severe eczema were more likely to suffer heart problems.

“Targeting cardiovascular disease prevention strategies among these patients should be considered”

Study authors

They found those with severe eczema had a 20% increased risk of stroke and between a 40% to 50% increased risk of unstable angina, heart attack, irregular heartbeat and cardiovascular death. Meanwhile, people in this group had an almost 70% increased risk of heart failure.

In addition, the researchers found the risk was greatest for those with severe or more active eczema.

They said that establishing a link between eczema and cardiovascular disease had important public health implications given how common the skin condition is.

For example, there could be a case for targeted screening for adults with atopic eczema, they suggested in the British Medical Journal.

”Severe and predominantly active atopic eczema are associated with an increased risk of cardiovascular outcomes. Targeting cardiovascular disease prevention strategies among these patients should be considered,” they said in their study paper.

In a linked editorial in the same journal, Dr John Ingram, a consultant dermatologist at Cardiff University, said the study results had helped to clarify the conflicting evidence regarding atopic eczema and cardiovascular risk, making the case for targeted screening of standard cardiovascular disease risk factors.

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