Atopic dermatitis, hypertension, and cardiovascular risk: an appraisal of the evidence

Atopic dermatitis is the most common chronically or chronically relapsing inflammatory skin disease, characterized by intense pruritus, eczematous lesions, and a significant disease burden. Emerging evidence in recent years suggests that atopic dermatitis and the associated chronic systemic inflammation have health implications beyond the skin. For psoriasis, another chronic inflammatory skin disease, the association with cardiovascular diseases (CVDs) is well-established. Recent studies have demonstrated a similar association between atopic dermatitis and CVDs such as hypertension, atherosclerosis, myocardial infarction, and major cardiovascular events. CVDs are the leading cause of death in the USA and Europe, and information about a heart-healthy lifestyle for patients at heightened risk is important. This narrative review focuses on recent studies investigating the association between atopic dermatitis and hypertension, ischemic heart disease including myocardial infarction and coronary heart disease, cardiac arrhythmias, and the association between atopic dermatitis, cardiovascular diseases, and a sedentary lifestyle. The associations between atopic dermatitis and CVDs appear to be more pronounced for moderate to severe disease across all included cardiovascular conditions in this review, suggesting a potential impact from systemic inflammation linked to atopic dermatitis. However, it remains uncertain whether the increased cardiovascular risk is directly attributable to the inflammatory nature of atopic dermatitis or may result from reduced physical activity commonly seen in these patients.