Association between atopic dermatitis and hypertension: a systematic review and meta-analysis

Background Previous studies have found conflicting results about the association of atopic dermatitis (AD) with hypertension. Objectives To determine whether AD and AD severity are associated with hypertension. Methods A systematic review was performed of published studies in Ovid MEDLINE, Embase, Scopus, Web of Science, and GREAT (Global Resource for EczemA Trials) databases. At least two reviewers conducted title/abstract, full-text review and data extraction. Quality of evidence was assessed using the Newcastle-Ottawa Scale. Results Fifty-one studies met the inclusion criteria and 19 had sufficient data for meta-analysis. AD was associated with higher odds of hypertension compared with healthy controls [increased in nine of 16 studies; pooled prevalence 16 center dot 4% vs. 13 center dot 8%; random-effects regression, pooled unadjusted odds ratio (OR) 1 center dot 16, 95% confidence interval (CI) 1 center dot 04-1 center dot 30], but lower odds of hypertension compared with psoriasis [decreased in five of eight studies; 15 center dot 4% vs. 24 center dot 8% (OR 0 center dot 53, 95% CI 0 center dot 37-0 center dot 76)]. In particular, moderate-to-severe AD was associated with hypertension compared with healthy controls [increased in four of six studies; 24 center dot 9% vs. 14 center dot 7% (OR 2 center dot 33, 95% CI 1 center dot 10-4 center dot 94)]. Hypertension was commonly reported as an adverse event secondary to AD treatments, particularly systemic ciclosporin A. Limitations include lack of longitudinal studies or individual-level data, and potential confounding. Conclusions AD, particularly moderate-to-severe disease, was associated with increased hypertension compared with healthy controls, but with lower odds than for psoriasis.

Automated summary

Previous studies have shown conflicting results about the association between atopic dermatitis and hypertension. This systematic review found that AD, particularly moderate-to-severe disease, was associated with increased hypertension compared with healthy controls, but with lower odds than for psoriasis. Hypertension was commonly reported as an adverse event secondary to AD treatments, particularly systemic ciclosporin A.