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A cross-sectional study on cardiac autonomic functions in psoriasis patients

Neha Aggarwal, Jyotsna Shukla, Saroj Purohit, Amit Tak, Bhoopendra Patel.




Abstract

Background: Psoriasis is a chronic, genetically determined and immune-mediated inflammatory disease of unknown etiology with a prevalence of 0.44–2.8% in India. The literature reports an increased risk of cardiovascular diseases in psoriatic patients. The present study was designed to explore the autonomic nervous system functions in psoriatic patients.

Aim and Objective: The objective of the present study was to assess cardiac autonomic functions in psoriasis patients aged 30–40 years as compared to age- and sex-matched healthy controls.

Materials and Methods: The present study was conducted in the Department of Physiology, SMS Medical College, Jaipur. Forty psoriatic patients of both genders were recruited from the Dermatology Department and forty, age- and gender-matched healthy subjects were taken as controls subjects from among employees of SMS Medical College, Jaipur. Prior approval and consent were obtained by the institutional ethics committee and institutional research review board. Parasympathetic function tests include E:I ratio, 30:15 ratio (lying to standing ratio), and Valsalva ratio; sympathetic function tests included blood pressure (BP) response to standing and sustained hand grip.

Results: Change in diastolic BP during isometric hand grip exercise was significantly lower in psoriasis patients (P < 0.05). Change in systolic BP on immediate standing was higher in psoriasis group (P < 0.05). E:I ratio, Valsalva ratio, and 30:15 ratio were also significantly decreased (P < 0.05) in psoriasis patients as compared to the healthy controls.

Conclusion: The deranged autonomic function tests in psoriasis patients suggested definite cardiac autonomic dysfunction. Autonomic dysfunction might put the psoriasis patients at greater cardiovascular disease risk. Therefore, autonomic function assessment of psoriasis patients is necessary for a better prognosis.

Key words: Psoriasis; Sympathetic; Parasympathetic; Cardiovascular






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