Childhood atopic dermatitis not linked to cardiovascular risk

Data published in JAMA Network Open has highlighted no correlation between atopic dermatitis (AD) in children and adolescents with increases in markers of cardiovascular risk.¹

An increase in data linking AD and cardiovascular disease (CVD) has been reported, including AD in adults being linked to increased risks of stroke, heart failure, and myocardial infarction.² However, other studies have reported no association, and there are currently no recommendations for screening.¹

“Limited data suggest that children with AD may have higher rates of cardiovascular risk factors, but most studies have been cross-sectional in nature and have not adequately adjusted for factors such as [body mass index (BMI)],” wrote investigators.

Assessing cardiovascular risk

The study was conducted to evaluate the impact of childhood AD on cardiovascular risk factors. Data were obtained from the Avon Longitudinal Study of Parents and Children, which recruited pregnant women with expected delivery between April 1, 1991, and December 31, 1992.

Patients without available AD or CVD data were excluded from the analysis. Race was included as a covariate and was reported as White or non-White. Active AD was the primary exposure and defined by at least 2 positive responses to a question asking parents if their child had itchy, dry skin rash in the joints and creases of the body in the past year.

Child AD symptoms were reported at aged 6, 18, 30, 42, 57, 69, 81, 103, 128, 140, and 166 months. Participants also self-reported their own AD symptoms at 16 and 18 years. Parents rated their child’s AD as no problem, mild, very bad, or quite bad. Five disease trajectory phenotypes were used to determine cumulative disease risk in the first 14 years of life.

Cardiovascular risk markers and patient demographics

Cardiovascular risk markers were measured at 12 different times when children were aged 3 to 24 years. These included the mean of 2 readings of systolic and diastolic blood pressure, BMI determined by height and weight, plasma lipid concentrations, and low-density lipoprotein cholesterol (LDL-C).

A validated cardiovascular risk score was reported as the primary outcome, calculated at aged 15, 17, and 24 years using systolic and diastolic blood pressure, abdominal fat mass, fasting plasma glucose, high-density lipoprotein cholesterol (HDL-C), and triglycerides. Covariates included birth characteristics, socioeconomic status, maternal educational attainment, and tobacco smoke exposure.

There were 9281 participants included in the final analysis, 49.69% of whom were female and 95.74% were White. In patients aged 3 to 18 years, an active AD rate of 13.10% to 21.58% was reported, with 3.52% to 6.85% reporting moderate to severe disease.

Cardiovascular outcomes

A median cardiovascular risk score of -0.47 was reported for patients without AD vs -0.25 for those with AD, indicating no significant difference in risk. Additionally, no associations were reported between AD and cardiovascular risk scores at the ages of 15 and 17 years, with adjusted mean differences of 0.11 and 0.09, respectively.

AD was also not linked to individual cardiovascular risk factors. Forty-nine comparisons were conducted, and only 2 associations were identified. These included increased LDL-C levels at the age of 10 years and decreased LDL-C levels at the age of 3 years, with mean differences of 0.14 and -0.33, respectively.

More active and severe AD was also not linked to cardiovascular risk factors at the ages of 17 and 24 years. The only associations reported included decreased HDL-C levels at aged 17 and 24 years and increased diastolic blood pressure at aged 17 years. Overall, the data indicated no significant impact of childhood AD on cardiovascular risk.

“These findings suggest that widespread screening of children and adolescents with AD for early markers of cardiovascular risk is unlikely to improve the identification of individuals in need of early intervention,” wrote investigators.

References

1. Ye M, McCulloch CE, Iribarren C, Langan SM, Abuabara K. Atopic dermatitis and markers of early cardiovascular risk in children and adolescents. JAMA Netw Open. 2026;9(3):e262962. doi:10.1001/jamanetworkopen.2026.2962
2. Ascott A, Mulick A, Yu AM, et al. Atopic eczema and major cardiovascular outcomes: a systematic review and meta-analysis of population-based studies. J Allergy Clin Immunol. 2019;143(5):1821-1829. doi:10.1016/j.jaci.2018.11.030