Hidradenitis Suppurativa Linked to Higher Cardiovascular Risk: Meta-Analysis
Key Takeaways
- A systematic review and meta-analysis of 25 studies included more than 373,000 individuals with hidradenitis suppurativa (HS) and found a substantial burden of cardiovascular comorbidities.
- Individuals with HS had approximately 1.3- to 1.8-fold higher relative risks across several cardiovascular outcomes and all-cause mortality vs those without HS.
- The level of certainty of evidence was low.
Hidradenitis suppurativa (HS) was associated with increased risk of multiple cardiovascular outcomes in a systematic review and meta-analysis encompassing 373,689 individuals with the chronic inflammatory skin disease.
Cardiovascular Comorbidities and Hidradenitis Suppurativa
Investigators sourght to evaluate the prevalence of cardiovascular comorbidities in HS and compared cardiovascular outcomes among individuals with and without HS. They conducted database searches (CINAHL, Cochrane, Embase, PubMed, and Scopus) and included studies when HS was clinician-diagnosed or identified through medical records, diagnostic codes.
Twenty-five studies met inclusion criteria and included a total of 373,689 patients. Random-effects meta-analyses were used to generate pooled estimates, with risk of bias assessed using Joanna Briggs Institute checklists and certainty of evidence evaluated with GRADE. Hypertension was the most frequently reported cardiovascular comorbidity, affecting approximately one-quarter of patients with HS. Coronary artery disease, cerebrovascular disease, congestive heart failure, and myocardial infarction were also reported.
Patients with HS had increased relative risks for multiple outcomes compared to those without HS. Estimates ranged from 1.3- to 1.8-fold for ischemic or coronary heart disease, composite cardiovascular disease, myocardial infarction, heart failure, venous thromboembolism, and all-cause mortality.
The associations remained consistent in sensitivity analyses. The authors rated the certainty of evidence due to the observational nature of many of the included studies, as well as other confounding factors.
“HS is associated with a substantial burden of cardiovascular comorbidities and increased risk of several major cardiovascular outcomes,” the authors wrote in the absract. “These findings support the consideration of cardiovascular risk assessment in the clinical management of HS while highlighting the need for prospective studies with standardized cardiovascular outcome definitions and more consistent adjustment for key confounders.”
Source
Mense S, et al. British Journal of Dermatology. 2026. Doi:10.1093/bjd/ljag182