American researchers investigated the potential effects of chronic antihypertensive use on the rate of rosacea diagnosis. Previous case reports have documented acute onset rosacea associated with antihypertensive agents, but the investigators hypothesized that the vasodilatory effects of antihypertensives modulating peripheral vascular tone could reduce vascular damage and in fact reduce the rate of rosacea diagnosis. The study included 680 patients with hypertension treated either with vasodilators or thiazide diuretics who developed rosacea within the first five years of treatment. The vasodilator group included angiotensin-converting enzyme (ACE) inhibitors, angiotensin II receptor blockers, beta-blockers and calcium channel blockers, and patients on thiazide diuretics were the control group. Within the 680 patients, 553 were on vasodilators and 127 were on thiazide diuretics. The relative risk of developing rosacea was lower in the vasodilator group than the thiazide diuretic group (relative risk [RR] 0.56, p<0.0001). When the results were analyzed for each class of vasodilators there was a significant protective effect for ACE-inhibitors (RR 0.50), for angiotensin II receptor blockers (RR 0.69), for beta-blockers (RR 0.55), and for calcium channel blockers (RR 0.39). The protective effect was not found in the 40 non-white patients when the results were broken down by ethnicity.Abid R, Reid A, Zafar F, et al. Investigating the relationship between rosacea and use of vasodilatory medications in a hospital-wide population. J Am Acad Dermatol. 2021 Feb 9;S0190-9622(20)33243-6. doi: 10.1016/j.jaad.2020.11.070.
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