Cardiovascular Risk and Comorbidities in Patients with Rosacea: A Systematic Review and Meta-analysis

Abstract

The association between rosacea and cardiovascular disease remains controversial. A systematic review and meta-analysis of the literature, from inception to 15 February 2020, was performed to compare cardiovascular risk and comorbidities in individuals with and without rosacea. Twelve studies, involving 40,752 patients with rosacea, were included. Compared with controls, patients with rosacea had higher systolic blood pressure (standardized mean difference (SMD) 0.293, 95% confidence interval (CI) 0.054-0.532), diastolic blood pressure (SMD 0.309, 95% CI 0.003-0.615), total cholesterol (SMD 1.147, 95% CI 0.309-1.984), low-density lipoprotein (SMD 0.792, 95% CI 0.174-1.409), C-reactive protein (SMD 0.26, 95% CI 0.099-0.421), greater epicardial fat thickness (SMD 1.945, 95% CI 1.595-2.296), and higher incidence of hypertension (odds ratio (OR) 1.204, 95% CI 1.097-1.332) and insulin resistance (OR 2.338, 95% CI 1.187-4.605). This study reveals that patients with rosacea are predisposed to increased subclinical cardiovascular risk.

Keywords: dyslipidaemia; hypertension; meta-analysis; risk factor; rosacea; systematic review; cardiovascular disease.

Fig. 1

Flow diagram for study identification.

Fig. 2

Forest plots. The forest plots showed the pooled estimates of cardiovascular risk factors in patients with rosacea in comparison with controls. Compared with controls, patients with rosacea had higher systolic blood pressure, diastolic blood pressure, total cholesterol, low-density lipoprotein, and C-reactive protein. Carotid intima media thickness was similar between patients with rosacea and controls, but epicardial fat thickness was greater in rosacea patients than in controls. CI: confidence interval.

Fig. 3

Forest plots. Pooled analyses showed the incidence of hypertension and insulin resistance was significantly higher in patients with rosacea than in controls, but the incidence of metabolic syndrome and diabetes mellitus was similar in the 2 groups. CI: confidence interval.