Cardiovascular risk in patients with alopecia areata: a cross-sectional study

Abstract

Introduction:Numerous studies indicate that alopecia areata is associated with systemic inflammation with an increased serum level of proinflammatory cytokines. Recent studies have indicated a higher incidence of cardiovascular diseases in patients with alopecia areata. Objective: To evaluate the cardiovascular risk calculated with various scoring systems in patients with alopecia areata compared to the controls. Material and methods:In the present study, the cardiovascular risk was evaluated in 91 patients with alopecia areata and 47 controls with the use of QRESEARCH risk estimator version 3 (QRISK-3), Framingham Risk score -Coronary heart disease (FRS-CHD), Framingham Risk Score -Cardiovascular disease (FRS-CVD), Atherosclerotic Cardiovascular Disease (ASCVD) Risk Estimator Plus and Systematic Coronary Risk Evaluation (SCORE) risk charts.Results: An increased median QRISK-3 was observed in patients with alopecia areata compared to controls (1.2 [0.5-5.5] vs. 0.9 [0.2-3.2]; p < 0.05). Moreover, higher median FRS-CHD, FRS-CVD, ASCVD Risk Estimator Plus scores were detected in patients with alopecia areata compared to control subjects (4.5 (2.4-9) vs. 3.35 (1.5-6.7); 0.85 (0.1-2.4) vs. 0.45 (0.1-1) and 2.5 (0.7-8.2) vs. 1.9 (0.8-4.3), respectively). However, those differences were not statistically significant (p > 0.05). In patients with alopecia areata, a positive correlation was observed between QRISK-3 and the age of the patient, body mass index, systolic blood pressure, diastolic blood pressure, total cholesterol, LDL-cholesterol and triglycerides. Conclusions: Alopecia areata is associated with an increased cardiovascular risk. Regular cardiovascular screening should be recommended to every patient with alopecia areata.