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Can psoriasis cause heart disease?
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Can psoriasis cause heart disease?

People with moderate to severe psoriasis are more likely to get cardiovascular issues than those without psoriasis, show studies

Psoriasis, an autoimmune disorder which causes scaly itchy patches all over the body is not only an embarrassment but can also be a huge risk for serious heart diseases. Several studies have shown more cases of cardiovascular diseases and its risk factors in people with psoriasis (also referred to as ‘heartbreak of psoriasis’) than those without the skin condition.

A study published in The American Journal of Cardiology observed that 45 percent of people with psoriasis presented with acute coronary syndrome. According to a review of several studies published in the journal Cureus, people with psoriasis also have higher risks of heart problems, like blood pressure, cholesterol, obesity and diabetes.

Psoriasis as a risk factor

In an email interaction, Dr James Cireddu, invasive cardiologist and medical director of UH Harrington Heart & Vascular Institute, USA, told Happiest Health, people with psoriasis are at increased risk of atherosclerotic vascular disease (blood vessel blockages) including cardiovascular, cerebrovascular and peripheral vascular disease. “They may also have increased risk for cardiac arrhythmias (abnormal heart rhythms),” he says.

Dr Elizabeth Blair Solow, Department of Internal Medicine, Division of Rheumatic Diseases, UT Southwestern Medical Center, USA, adds in an email interaction with Happiest Health, people with cardiovascular conditions are more at risk for developing myocardial infarction, coronary artery disease, stroke and cardiovascular death. “Concerningly, several studies suggest even patients who were younger were at higher risk,” she says.

How does psoriasis affect the heart?

Experts say that though the connection between psoriasis and atherosclerotic disease (clotting of blood vessels due to deposition of fats, cholesterol and other substances) is not understood completely, chronic inflammation in both disorders is likely a key factor. “Both cutaneous and systemic inflammation combined with other common cardiovascular risk factors like high cholesterol, hypertension and smoking are thought to increase cardiovascular risk in people with psoriasis,” says Dr Cireddu.

Dr Aishwarya Radhakrishna, a Bengaluru-based dermatologist, explains, “There are certain genes which make a person predisposed to heart conditions, diabetes, or hypertension. The same genes are also responsible for psoriasis, which leads to increase in inflammation of the tissues. This, in turn, can promote atherosclerosis.”

She says people with moderate or severe psoriasis are at a higher risk of developing heart conditions, especially if they have additional risk factors. “Psoriasis is often observed in people who are 25 to 35 years and in the older population. The older population are more likely to have diabetes, cholesterol and other factors, which add up to the cardiovascular risk,” she adds.

Psoriatic arthritis and heart conditions

Some people with psoriasis are affected by arthritis too. Dr Solow says, “People with psoriasis may develop signs of inflammatory arthritis such as joint pain, swelling and stiffness. Most often, these symptoms of arthritis are diagnosed several years after psoriasis, though occasionally, the joint symptoms may precede that of the skin or manifest at the same time.”

The condition where the bones are involved is called psoriatic arthritis. Dr Solow adds that people with psoriatic arthritis are at higher risk than those with only psoriasis. However, both groups have an increased risk of cardiovascular diseases, compared to the general population.

Can psoriasis treatment reduce risk of heart disease?

Dr Cireddu says that many classes of drugs for psoriasis including tumor necrosis factor (TNF)-alpha inhibitors may reduce the risk of cardiovascular events.

However, Dr Solow adds some older immunosuppressants and newer classes of drugs like jak inhibitors may be associated with high blood pressure and elevated cholesterol, respectively. But jak inhibitors have not been shown to increase the risk of cardiovascular disease in people with psoriasis and psoriatic arthritis. “Visits to the specialist are important to discuss the risks and benefits of each medication to help prevent cardiovascular disease,” she says.

Preventing heart disease from psoriasis

Experts suggest the following measures to help prevent heart disease in people with psoriasis:

  • Limit systemic steroids and nonsteroidal anti-inflammatory drugs
  • Focus on physical activity and exercise regularly
  • Maintain a healthy body weight
  • Adopt a hearthealthy diet with low cholesterol and fat intake
  • Avoid smoking
  • Avoid stress
  • Control diabetes, blood pressure and cholesterol
  • Follow-up regularly on treatment for psoriasis with doctor
  • Consult a cardiologist if you are worried about the risk of developing heart disease

Takeaways

  • The autoimmune skin disorder, psoriasis can put one at a higher risk of heart diseases.
  • Though the connection between psoriasis and atherosclerotic disease is not well understood, chronic inflammation combined with other risk factors like high cholesterol, hypertension and smoking are thought to increase cardiovascular risk in people with psoriasis.
  • People with moderate or severe psoriasis and psoriasis arthritis are at a higher risk of developing heart conditions compared to those with mild psoriasis.
  • Experts recommend following a healthy lifestyle and regular consultations with doctors to help cut down the risk for heart diseases.

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