Patients With Vitiligo Face Elevated Risk of Cardiovascular Disease, Study Finds
Using real-world data from the US Collaborative Network (USCN), researchers found that individuals with vitiligo face a heightened risk of cardiovascular disease. The study analyzed data from 96 581 individuals with vitiligo, compared to an equal number of matched controls, and identified a significant association between vitiligo and increased rates of major cardiovascular events.
Over a 15-year follow-up period, 54 diagnoses were found to be more prevalent in patients with vitiligo, including key cardiovascular conditions. Notably, cerebral infarction occurred in 1.3% of patients with vitiligo vs 1.0% in controls, translating to a hazard ratio (HR) of 1.21 (95% CI, 1.11-1.32; P < .001). Similarly, venous thromboembolism was more frequent in the vitiligo group (1.34%) compared to controls (1.02%), with an HR of 1.27 (95% CI, 1.17-1.38; P < .001). The study also evaluated major adverse cardiovascular events (MACE) as a composite outcome, revealing an increased risk in individuals with vitiligo (HR, 1.28; 95% CI, 1.22-1.35; P < .001). This association remained significant across sensitivity analyses.
This study highlights the increased prevalence of cardiovascular diseases (CVDs) in patients with vitiligo, identifying 54 out of 94 cardiovascular diagnoses with a significantly elevated risk compared to those without vitiligo. The findings indicate a heightened risk for conditions such as myocardial infarction, pulmonary embolism, venous thrombosis, and heart failure, contradicting prior studies that reported lower CVD risks in patients with vitiligo, potentially due to differences in population demographics and study methodologies. It also identifies an increased risk of ischemic heart diseases, hypertensive kidney disease, sick sinus syndrome, and conduction disorders, while showing no correlation with aortic aneurysm or arrhythmic conditions.
The link between vitiligo and atherosclerosis is supported by prior research, although disease severity and subtypes could not be analyzed due to data limitations. While inflammatory mechanisms and treatment effects may contribute to CVD risk, causality remains unconfirmed, warranting further prospective or Mendelian randomization studies to clarify underlying pathophysiological mechanisms.
Reference
Frączek A, Owczarczyk-Saczonek A, Ludwig RJ, et al. Vitiligo is associated with an increased risk of cardiovascular diseases: a large-scale, propensity-matched, US-based retrospective study. eBioMedicine. 2024;109:105423. doi:10.1016/j.ebiom.2024.105423
