Cardiovascular Screening Practices and Statin Prescription Habits in Patients with Psoriasis among Dermatologists, Rheumatologists and Primary Care Physicians

Patients with psoriasis have a higher prevalence of cardiovascular risk factors. This study evaluated cardio-vascular screening practices and statin prescribing habits among dermatologists, rheumatologists and primary care physicians (PCPs) through an online questionnaire, which was distributed through the Spanish scientific societies of the above-mentioned specialties. A total of 299 physicians (103 dermatologists, 94 rheumatologists and 102 PCPs) responded to the questionnaire. Of these, 74.6% reported screening for smoking, 37.8% for hypertension, 80.3% for dyslipidaemia, and 79.6% for diabetes mellitus. Notably, only 28.4% performed global screening, defined as screening for smoking, hypertension, dyslipidaemia, and diabetes mellitus by the same physician, and 24.4% reported calculating 10-year cardiovascular disease (CVD) risk, probably reflecting a lack of comprehensive cardiovascular risk assessment in these patients. This study also identified unmet needs for awareness of cardiovascular comorbidities in psoriasis and corresponding screening and treatment recommendations among PCPs. Of PCPs, 61.2% reported not being aware of the association between psoriasis and CVD and/or not being aware of its screening recommendations, and 67.6% did not consider psoriasis as a risk-enhancing factor when deciding on statin prescription. Thirteen dermatologists (12.6%) and 35 rheumatologists (37.2%) reported prescribing statins. Among those who do not prescribe, 49.7% would be willing to start their prescription. SIGNIFICANCE Patients with psoriasis have an increased risk of cardiovascular events. This is partly due to a higher prevalence of smoking, hypertension, diabetes mellitus and dyslipidaemia. This study found that less than 30% of the physicians evaluated (dermatologists, rheumatologists and primary care physicians) performed global screening, defined as screening for hypertension, dyslipidaemia, smoking and diabetes mellitus by the same physician. In addition, more than 60% of the primary care physicians stated that they were unaware of the association between psoriasis and cardiovascular disease. Regarding treatment, 50% of dermatologists and rheumatologists who do not prescribe statins would be willing to start prescribing them.