Prevalence, incidence and relative risk of cardiovascular disease risk factors in adults with atopic dermatitis:A systematic review

Atopic dermatitis (AD) has been associated with cardiovascular disease(CVD). A better understanding of CVD risk factors in AD populations mayhelp dermatologists better counsel their patients regarding potential risks andtreatment choices. This systematic literature review evaluated the prevalence,absolute risk (i.e., incidence) and relative risk of CVD risk factors in adultswith AD. MEDLINE, Embase and The Cochrane Library were searched forEnglish‐language articles published between January 2005 and the search date(16–17 March 2021) using terms for AD, prevalence/risk and CVD risk factors.Observational studies that reported the prevalence, absolute risk and/orrelative risk of CVD risk factors in adults with AD were eligible. Of the 1277unique articles identified, 71 met the inclusion criteria. Most studies werecross‐sectional or retrospective cohort studies from Europe, North America orAsia; many used national databases. Studies were heterogeneous, withinconsistent definitions of AD and risk factors (especially smoking andobesity), different methodologies and different populations (e.g., ethnicity).Within most controlled studies, the prevalence of several risk factors,particularly obesity, hypertension and dyslipidemia, was higher for AD thanfor controls. Where assessed, the prevalence of most CVD risk factorsincreased with increasing AD severity. Relative risks varied across studies.Only nine studies reported the temporal relationship between AD and CVDrisk factors. Six studies reported absolute or relative risk of developing CVDrisk factors (diabetes, hypertension and smoking) in AD populations; only oneof these reported an elevated risk (hypertension). Despite the high number ofstudies to date, conclusive data regarding the relationship between AD andmany CVD risk factors are lacking, and additional, carefully designed,prospective studies are required.