Association between beta-blockers, other antihypertensive drugs and psoriasis : population-based case-control study

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 <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.