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Background Despite scarce evidence, use of calcium channel blockers is discouraged in patients with rosacea, whereas beta-blockers are recommended as an off-label treatment for erythematotelangiectatic rosacea. Objectives To study the association of the use of calcium channel blockers, beta-blockers and other antihypertensive drugs with incident rosacea. Methods We conducted a matched case-control study of antihypertensive drugs and incident rosacea, using the U.K.-based General Practice Research Database. Cases had an incident diagnosis of rosacea recorded between 1995 and 2009. Each case was matched to one control on age, sex, general practice and years of history on the database before the index date. Drug use was stratified by timing (≤ or > 180 days before the index date) and duration (number of prescriptions) of drug exposure, in a multivariate conditional logistic regression model. Results Among 53 927 cases and 53 927 controls, we observed odds ratios (ORs) around unity for calcium channel blockers across all strata, with a slightly decreased OR of 0⋅77 (95% CI 0⋅69-0⋅86) for current users of dihydropyridine calcium channel blockers with ≥ 40 prescriptions. Among beta-blockers, atenolol and bisoprolol yielded slightly decreased ORs across all exposure strata, whereas propranolol revealed ORs around 1⋅0, irrespective of timing and duration of exposure. Neither angiotensin-converting-enzyme inhibitors nor angiotensin receptor blockers altered the relative rosacea risk. Conclusions Our data contradict the prevailing notion that calcium channel blockers increase the risk of rosacea. Beta-blocker use was associated with a slightly decreased risk of rosacea, but the effect may be somewhat stronger in patients with erythematotelangiectatic rosacea. [ABSTRACT FROM AUTHOR]

Background Systemic inflammation may increase the risk for cardiovascular diseases in patients with psoriasis, but data on this risk in patients with early psoriasis are scarce. Objectives To assess and compare the risk of developing incident myocardial infarction (MI), stroke or transient ischaemic attack (TIA) between an inception cohort of patients with psoriasis and a psoriasis-free population. Methods We conducted an inception cohort study with a nested case–control analysis within the U.K.-based General Practice Research Database. The study population encompassed 36 702 patients with a first-time recorded diagnosis of psoriasis 1994–2005, matched 1 : 1 to psoriasis-free patients. We assessed crude incidence rates (IRs) and applied conditional logistic regression to obtain odds ratios (ORs) with 95% confidence intervals (CIs). Results Overall, the IRs of MI ( n = 449), stroke ( n = 535) and TIA ( n = 402) were similar among patients with or without psoriasis. However, the adjusted OR of developing MI for patients with psoriasis aged < 60 years was 1·66 (95% CI 1·03–2·66) compared with patients without psoriasis, while the OR for patients aged ≥ 60 years was 0·99 (95% CI 0·77–1·26). The adjusted ORs of developing MI for patients of all ages with ≤ 2 or > 2 prescriptions/year for oral psoriasis treatment were 2·48 (95% CI 0·69–8·91) and 1·39 (95% CI 0·43–4·53), with a similar finding for stroke and TIA. Conclusions The risk of developing a cardiovascular outcome was not materially elevated for patients with early psoriasis overall. In subanalyses, however, there was a suggestion of an increased (but low absolute) MI risk for patients with psoriasis aged < 60 years, mainly with severe disease. [ABSTRACT FROM AUTHOR]

Background Several case reports have associated use of beta-blockers with an increased risk of psoriasis or psoriasiform drug eruptions. Objectives To study the association between use of beta-blockers and other antihypertensive drugs and the risk of developing a first-time diagnosis of psoriasis. Methods We conducted a case–control analysis on the U.K.-based General Practice Research Database. We identified cases with an incident psoriasis diagnosis between 1994 and 2005 and matched them to one control patient on age, sex, general practice, calendar time (same index date) and years of history in the database. Conditional logistic regression was used to estimate adjusted odds ratios (ORs) with 95% confidence intervals (CIs) of developing a first-time psoriasis diagnosis in relation to previous exposure to antihypertensive drugs, stratified by exposure timing (current vs. past use) and exposure duration based on the number of prescriptions. Results The study encompassed 36 702 cases with a first-time psoriasis diagnosis and the same number of matched controls. Adjusted ORs for current use of 1–4, 5–19 or ≥ 20 prescriptions for beta-blockers, as compared with nonuse, were 0·93 (95% CI 0·76–1·13), 1·10 (95% CI 0·97–1·24), and 1·10 (95% CI 1·01–1·20), respectively. The risk estimates for current use of other antihypertensives at any exposure duration were all close to 1·0. Conclusions This large population-based case–control analysis does not support the current proposition that beta-blocker use is associated with an increased risk of psoriasis, nor did we find evidence for a substantially altered psoriasis risk for other antihypertensive drugs. [ABSTRACT FROM AUTHOR]