3.6 million Americans living with active, undiagnosed psoriasis, unaware of associated risks

Armed with research concluding that psoriasis is associated with an increased risk of heart attacks and other cardiovascular conditions, Joel M. Gelfand, MD, MSCE, Assistant Professor of Dermatology at the University of Pennsylvania School of Medicine and colleagues released an editorial consensus in the American Journal of Cardiology today, calling for psoriasis patients to be educated about and screened for cardiovascular risk factors.

Dr. Gelfand's latest research estimates that, in addition to the seven million Americans adults diagnosed with psoriasis, as many as 3.6 million Americans are living with active, undiagnosed psoriasis, unaware of the associated cardiovascular risk.

Dr. Gelfand's previously published research, a focal point of the AJC consensus advisory, showed that patients with psoriasis have an increased risk of cardiovascular disease and heart attacks, particularly if their psoriasis is moderate to severe. In the largest study of nonhospitalized patients with psoriasis and coronary artery disease to date, where more than 130,000 patients were tracked for 5.4 years, Gelfand et al determined that psoriasis is an independent risk factor for a heart attack. Other research shows that hypertension, diabetes, elevated cholesterol, and obesity are also more common in patients with psoriasis than in the general population.

"Psoriasis patients, particularly those with severe disease, should be educated about their increased risk of blocked arteries and heart attacks, screened for major cardiovascular risk factors -- such as elevated blood pressure or cholesterol -- and treated for modifiable cardiovascular risk factors," recommends Dr. Gelfand. "Psoriasis patients are encouraged to make lifestyle adjustments that will improve their overall cardiovascular health."

In a separate article, published online in the Journal of the American Academy of Dermatology , Dr. Gelfand and University of Pennsylvania School of Medicine doctoral candidate Shanu Kohli Kurd, MHS, estimated that 600,000 to 3.6 million Americans are living with undiagnosed active psoriasis. A disparity was found as well - undiagnosed patients were more likely to be male, nonwhite, less educated and unmarried, compared to diagnosed patients.

"Given the serious medical conditions often associated with psoriasis, including metabolic disorders and cardiovascular disease, it is very important for people with a persistent rash to seek medical attention, especially if the rash is quite extensive," said Dr. Gelfand.

The consensus paper was supported by an educational grant from Amgen. Dr. Gelfand has received consulting fees from Amgen; Genentech; Pfizer, New York, New York; Celgene, Summit, New Jersey; and Centocor, Horsham, Pennsylvania. Dr. Gelfand is a grants investigator for Amgen, Centocor, and Pfizer.

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Penn's School of Medicine is currently ranked #4 in the nation in U.S.News & World Report's survey of top research-oriented medical schools; and, according to most recent data from the National Institutes of Health, received over $379 million in NIH research funds in the 2006 fiscal year. Supporting 1,700 fulltime faculty and 700 students, the School of Medicine is recognized worldwide for its superior education and training of the next generation of physician-scientists and leaders of academic medicine.

The University of Pennsylvania Health System (UPHS) includes its flagship hospital, the Hospital of the University of Pennsylvania, rated one of the nation's top ten "Honor Roll" hospitals by U.S.News & World Report; Pennsylvania Hospital, the nation's first hospital; and Penn Presbyterian Medical Center. In addition UPHS includes a primary-care provider network; a faculty practice plan; home care, hospice, and nursing home; three multispecialty satellite facilities; as well as the Penn Medicine at Rittenhouse campus, which offers comprehensive inpatient rehabilitation facilities and outpatient services in multiple specialties.

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