Racial Variations in Cardiovascular Outcomes Found in Hidradenitis Suppurativa Study

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Findings from a poster presented at the 2024 American Academy of Dermatology Annual Meeting show significant variations in cardiovascular outcomes and abnormal serum laboratory values among different racial groups afflicted with hidradenitis suppurativa (HS), suggesting the imperative for health care providers to recognize and address the impact of race on disease management in these patients.

HS is a chronic inflammatory skin disorder characterized by painful abscesses and nodules, often linked with obesity and metabolic syndrome. Although the cardiovascular comorbidities of HS have been acknowledged, the influence of race on these outcomes is limited. This research aimed to investigate variations in cardiovascular outcomes and abnormal serum laboratory values associated with HS across different racial groups.

In this study, cardiovascular outcomes and serum lab abnormalities were compared among several racial cohorts | Image credit: Prostock-studio - stock.adobe.com

Investigators conducted a retrospective cohort study utilizing the TriNetX platform. Patients aged 18 to 80 years with HS diagnosed within the past decade were included. The study encompassed individuals identifying as African-American/Black, American Indian/Alaska Native, Asian, Native Hawaiian/Pacific Islander, and White. Relative risk calculations were employed to compare cardiovascular outcomes and serum lab abnormalities among racial cohorts.

The study unveiled that Black and Asian patients exhibited a higher prevalence of cardiovascular issues and abnormal serum values compared with their White counterparts with HS. Concerning lipid profiles, Black, American Indian, and Pacific Islander patients demonstrated unfavorable levels of low-density lipoprotein (LDL) cholesterol and monocytes in contrast with White patients.

The analysis of diagnostic outcomes exhibited significant disparities in myocardial infarction (MI) prevalence observed across racial groups, with African American/Black patients showing comparable odds of MI to White patients (OR, 1.00; 95% CI, 0.87-1.14; P > .90) but lower odds compared with patients of other races (OR, 0.56; 95% CI, 0.37-0.99; P = .05). Hyperlipidemia prevalence also varied significantly by race, with African American/Black patients exhibiting higher odds than White patients (OR, 1.28; 95% CI, 1.22-1.36; P < .001), while biologic treatment was associated with lower odds of hyperlipidemia across all racial groups (OR, 0.69; 95% CI, 0.57-0.83; P < .001).

Additionally, the likelihood of RDW ≥ 14.6% (a measure of red blood cell distribution width) differs by race, with White patients displaying higher odds when compared with racial groups (OR, 0.97, 95% CI, 0.79–1.19; P < .80) other than those who are African American/Black (OR, 0.52; 95% CI, 0.49–0.55; P < .001). Although biologic treatment is associated with increased odds of RDW ≥ 14.6%, irrespective of race (OR, 1.56; 95% CI 1.33–1.91; P < .001). Similarly, LDL cholesterol levels ≥ 125.1 mg/dL varied significantly by race, with White patients again showing higher odds compared with patients of other races (OR, 1.09 to 1.43, P < .001), while biologic treatment is associated with lower odds of elevated LDL cholesterol levels, with a significant interaction observed between race and biologic treatment (P = 0.04).

It was noted in the study that its retrospective nature and reliance on electronic health records may introduce biases or limitations inherent in such data sources. Additionally, the study's sample size and demographic distribution could influence the generalizability of the findings. Further prospective studies with larger and more diverse cohorts are essential to validate and expand upon these findings.

Based on their findings, the investigators acknowledged the critical need to consider racial differences when assessing and managing patients with HS. Health care providers should be particularly vigilant in addressing cardiovascular risk factors in this population, recognizing and addressing racial disparities that may impact disease management.

Reference

Ofori-Darko A, Treichel A, McCormick T, Cooper K. Racial disparities in cardiovascular outcomes and serum lab values In hidradenitis suppurativa: a multivariate analysis. Presented at: American Academy of Dermatology Annual Meeting; March 8-12, 2024; San Diego, CA. Poster 50106.