Atopic eczema, especially when severe and “predominantly active”, seems to increase cardiovascular risk, according to UK research. And, it may account for one in 50 cases of unstable angina and heart failure.

Researchers matched the medical records of 387,439 patients with atopic eczema to 1,528,477 controls. During a median follow up of 5.1 years, patients with severe atopic eczema (e.g. those who needed systemic immunosuppressant drugs, phototherapy or referral) were 22 per cent more likely to experience a stroke than controls. Such patients were also more likely to die from cardiovascular causes (by 38 per cent), need coronary revascularisation (47 per cent) and develop atrial fibrillation (38 per cent), myocardial infarction (41 per cent), unstable angina (48 per cent) and heart failure (69 per cent).

People with mild and moderate eczema were at increased risk of some cardiovascular outcomes such as angina heart failure, atrial fibrillation and stroke.

Patients whose atopic eczema was active during more than half of the follow-up time were also at increased cardiovascular risk. Adjusting for other cardiovascular risk factors reduced the strength of the associations but many remained statistically significant, especially for severe atopic eczema. The authors estimate that eczema might account for 2.4 per cent of cases of unstable angina and 1.9 per cent of cases of heart failure in the population.

The increased cardiovascular risk seems to arise from the systemic inflammation that underlies atopic dermatitis. “Consideration should be given to developing prevention strategies to reduce the risk of cardiovascular disease among patients with severe or predominantly active atopic eczema, including awareness of and screening for conventional cardiovascular risk factors,” the authors conclude.