Atopic dermatitis and skin disease
Eczema and cardiovascular risk factors in 2 US adult population studies

https://doi.org/10.1016/j.jaci.2014.11.023Get rights and content

Background

Eczema is associated with high rates of sleep disturbance and quality-of-life impairment. These factors might have a negative impact on psychosocial development and behavior and could increase cardiovascular risk.

Objective

We sought to determine whether adults with eczema have increased cardiovascular risk factors.

Methods

We analyzed data for 27,157 and 34,525 adults aged 18 to 85 years from the 2010 and 2012 National Health Interview Survey.

Results

Adults with eczema had higher odds of ever smoking 100 cigarettes in their lifetime (survey logistic regression; adjusted odds ratio [aOR], 1.32; 95% CI, 1.18-1.47) and current smoking history (aOR, 1.28; 95% CI, 1.12-1.45), with significantly younger age of onset (survey linear regression; adjusted β, −0.58; 95% CI, −0.95 to −0.21). Eczema was also associated with greater odds of ever drinking 12 or more alcoholic beverages annually (aOR, 1.16; 95% CI, 1.03-1.31), including current intake of moderate (aOR, 1.33; 95% CI, 1.09-1.62) and heavier (aOR, 1.58; 95% CI, 1.23-2.03) amounts. Adults with a history of eczema had lower odds of daily vigorous activity (aOR, 0.79; 95% CI, 0.63-0.99) and lower frequency of vigorous activity in the past week (adjusted β, −0.46; 95% CI, −0.72 to −0.21) than did adults without a history of eczema. Those with eczema had a higher body mass index than did those without eczema (adjusted β, 0.86; 95% CI, 0.37-1.36), particularly a body mass index of 35 or more (aOR, 1.54; 95% CI, 1.16-2.05), and higher odds of hypertension (aOR, 1.48; 95% CI, 1.18-1.85), hypertension on 2 visits (aOR, 1.56; 1.22-1.99), and lifetime prediabetes (aOR, 1.71; 95% CI, 1.19-2.45). Finally, there were significant interactions between eczema and sleep disturbances such that eczema associated with fatigue, daytime sleepiness, or insomnia was associated with even higher odds of obesity, hypertension, hypertension on 2 visits, prediabetes, diabetes, and high cholesterol than eczema alone.

Conclusions

We found that eczema in adults is a marker for cardiovascular risk, emphasizing the importance of behavioral modification and perhaps more aggressive interventions to better manage eczema.

Section snippets

National Health Interview Survey

The institutional review board at Northwestern University approved this study, and the protocol is consistent with the principles of the Declaration of Helsinki. We used data from the 2010 and 2012 National Health Interview Survey (NHIS), which are conducted by the National Center for Health Statistics and are the principal source of information on the health of the civilian noninstitutionalized population of the United States. The survey was administered in-person to selected households by

Determinants of eczema, diabetes, and hypertension

A total of 34,525 adults aged 18 to 85 years was included in the analysis of the 2012 NHIS. The US prevalence (95% CI) of eczema in adults was estimated to be 7.2% (6.9 to 7.6%). The prevalence of eczema was significantly associated with female sex (logistic regression; OR, 1.52; 95% CI, 1.36-1.70; P < .001) and post–high school education (OR, 1.39; 95% CI, 1.15-1.68; P < .001) but inversely associated with black race (OR, 0.79; 95% CI, 0.64-0.93; P = .01), Hispanic origin (OR, 0.73; 95% CI,

Discussion

Using 2 US population–based cohorts, we found that adults with eczema had higher rates of cigarette smoking and consumption of alcoholic beverages, lower rates of vigorous activity, and higher prevalence of class II/III obesity, hypertension, prediabetes, diabetes, and high cholesterol. These results could have major clinical and public health ramifications because smoking, alcohol intake, and sedentary lifestyle are all modifiable risk factors. Patients with AD may be candidates for aggressive

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    Disclosure of potential conflict of interest: The authors declare that they have no relevant conflicts of interest.

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