Psoriasis is associated with multiple comorbidities, including psoriatic arthritis, diabetes mellitus, hypertension, metabolic syndrome, depression, and increased alcohol and tobacco use. Overall, cardiovascular (CV) comorbidities present the greatest
risk to patient health. Compared with the general population, patients with psoriasis are at an increased risk for developing CV risk factors. For instance, patients with severe psoriatic disease are 5 times more likely than patients without psoriasis to require antihypertensive
medications, have a 2-fold higher risk for myocardial infarction, and have a decreased life span by as much as 4 years.1-3
The National Psoriasis Foundation released CV risk screening guidelines in 2008.4 The frequency with which dermatologists and nondermatologists screen psoriasis patients for CV risk factors is not well characterized in the medical literature. Therefore, the main objective of this study was to determine how often CV risk factors are screened for during outpatient visits. In addition, we assessed how patient demographics and outpatient clinic characteristics
are associated with CV risk screening rates.
This study is a retrospective analysis. Data from the National
Ambulatory Medical Care Survey (NAMCS) from 2005 to 2009 were used to assess how often psoriasis patients were screened for CV risks at outpatient visits. The NAMCS is an ongoing survey of non–federally employed, office-based physician
practices in the United States. It has been conducted by the National Center for Health Statistics since 1974 to estimate the use of ambulatory care services in the United States. For each visit sampled, a 1-page patient log is completed, which includes information such as patient demographics, presenting symptoms,
physicians' diagnoses, and services provided, including diagnostic tests, medications, and referral practices. Collected data are entered into a multistage probability sample to produce
national estimates regarding the utilization of ambulatory care services in the United States.
The NAMCS was queried for data regarding psoriasis and nonpsoriasis
patient visits from 2005 to 2009. Psoriasis visits were identified using International Statistical Classification of Dis-