Heart disease: Why people with severe psoriasis are at higher risk

Evan Walker
Evan Walker TheMediTary.Com |
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Researchers say psoriasis can exacerbate conditions that increase the risk of cardiovascular disease. NICK VEASEY/SCIENCE PHOTO LIBRARY/Getty Images
  • Researchers report that psoriasis is linked to an increased risk of heart disease.
  • They say that inflammation plays a role in this, but the precise mechanisms are unclear.
  • Early intervention and effective treatment plans may help reduce cardiovascular risks.

Globally, psoriasis affects an estimated 125 million people around the world.

Despite its prevalence, this immune-mediated dermatological condition still holds many mysteries.

Aside from psoriatic lesions on the skin, this condition can also influence less visible parts of the body.

One important example is its links to an increased risk of cardiovascular events. This increase in risk is independent of traditional cardiovascular risk factors, such as smoking, age, diabetes, and hypertension.

Medical News Today spoke with Dr. Joel Gelfand, a professor of dermatology and epidemiology at the University of Pennsylvania Perelman School of Medicine about the disease.

“There are many lifestyle, genetic, and immunologic connections between psoriasis and cardiovascular disease,” he explained.

He noted that scientists have known about this link for many years and it is an important area of research.

“The more extensive psoriasis is on the skin, the greater risk the patient has of heart attack, stroke, and mortality,” said Gelfand, who wasn’t involved in the study. “Underdiagnosed and undertreated, traditional cardiovascular risk factors in psoriasis patients are also critical to mediating this relationship.”

A recent study, which appears in the Journal of Investigative Dermatology, uses a new approach to investigate the precise mechanisms behind psoriasis and cardiovascular disease.

CMD affects the tiny blood vessels that supply the cardiac muscle. Like coronary artery disease, inflammation seems to be a driving factor in CMD.

However, while coronary artery disease and CMD are related, according to the authors of the recent paper, they “may play different roles in the pathogenesis of vascular disease.”

Some existing evidence suggests that the increased cardiovascular risk in people with psoriasis may be due to CMD, but previous investigations have been small in scale.

The latest study set out to replicate those findings in a larger group.

Because CMD affects the smallest blood vessels, most standard medical procedures cannot detect it. So, in this study, the researchers used a measure called coronary flow reserve, which can detect both coronary artery disease and CMD.

Gelfand explained how he and his colleagues are also investigating other ways of assessing cardiovascular risk in people with psoriasis.

“The risk of future cardiovascular events can be further refined with cardiac imaging, such as a coronary artery calcium score,” he said. “We are testing a novel, centralized, care coordination model to help psoriasis patients get better screening for, and management of, traditional cardiovascular risk factors. Our preliminary data is quite promising.”

In the future, using a range of scanning and diagnostic technology might help assess and address cardiac risk earlier in this population.

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