Atopic Dermatitis in Kids Linked with Hypertension, Weight Gain

By David Douglas

NEW YORK (Reuters Health) - Children with moderate to severe atopic dermatitis are at heightened risk of high systolic blood pressure (BP) and central obesity, according to an observational study.

"These results suggest that people with severe atopic dermatitis are at higher risk for cardiovascular disease," Dr. Jonathan Silverberg, of Northwestern University Feinberg School of Medicine, Chicago, told Reuters Health by email,

In a December 23rd online paper in JAMA Dermatology, Dr. Silverberg and colleagues note that little is known about whether risk factors for metabolic disease, such as central versus general obesity and elevated BP, are also increased in children with atopic dermatitis.

To investigate, the researchers studied 132 children aged 4 to 17 years with active disease and 143 comparable healthy controls.

They found that atopic dermatitis was associated with higher BP for age, sex, and height percentiles, particularly a systolic BP in the 90th percentile or higher (odds ratio, 2.06). They linked atopic dermatitis with body mass index (BMI) for age and sex of the 97th percentile or greater.

In multivariate models that controlled for demographics, BMI, waist circumference percentiles and other factors, the researchers found systolic BP significantly greater in Hispanics/Latinos and Asians (both p=0.02).

Overall, the investigators write, the findings indicate that atopic dermatitis may be linked with relative increases of BP that might go undetected because levels are not extremely high.

"The long-term sequelae of increased BP are unknown in children," they add, "but it is possible that cumulative increases of BP are associated with cardiovascular disease later in life, similar to that observed in psoriasis."

Summing up, Dr. Silverberg added that the findings "certainly suggest" a particular need for BP monitoring in children with atopic dermatitis.

Commenting by email, Dr. Dawn Davis, author of an accompanying editorial, told Reuters Health that despite atopic dermatitis being common, "there are no treatment options (that) put the disease into permanent remission. It is a disease we currently treat but not cure. This is very frustrating for patients, caregivers, and medical providers."

Dr. Davis, of the Mayo Clinic in Rochester, Minnesota, concluded, "Atopic dermatitis is most likely a multifactorial disease. Further research is needed . . . . Perhaps the management and treatment of atopic dermatitis will be more successful if comorbidities are identified and addressed."

SOURCE: https://bit.ly/13T5KSh

JAMA Dermatol 2014.

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