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.