Features May 2012 Issue

Learn the Connection Between Psoriasis and Heart Disease

Research shows that this common skin condition can increase your risk of cardiovascular problems.

If you suffer from psoriasis, you may want to pay even greater attention to your heart health. A study published in the April 1 issue of the American Journal of Cardiology found that psoriasis patients are at a greater risk for coronary artery disease (CAD) than those without the chronic skin disease. And the longer you’ve had psoriasis, the higher your heart risks.

Psoriasis is characterized by the rapid growth of skin cells and a thickening of the skin. The outer layer of skin becomes irritated and skin flakes off.

But how are the conditions linked?

“Coronary artery disease is believed to have an inflammatory basis,” says Richard Krasuski, MD, a cardiologist at Cleveland Clinic. “Atherosclerotic plaques may be triggered by inflammatory changes in the vessel wall and changes to cholesterol particles in the blood are seen with inflammation that leads to greater cholesterol deposition in the vessel. Inflammation may even trigger plaque rupture, which can lead to occlusion of a heart vessel and a heart attack.”

According to Dr. Krasuski, patients with psoriasis, in addition to having skin lesions, have signs of inflammation in their bloodstream and there is growing evidence that they can develop premature atherosclerosis, which leads to an increased risk of heart attack.

“We know that many patients with psoriasis are overweight, have hypertension, hyperlipidemia, and insulin resistance,” adds Irene C. Lalak, MD, a dermatologist at Cleveland Clinic. “These are all risk factors for coronary artery disease and stroke. But, psoriasis itself is an independent risk factor for coronary artery disease, and the more severe the psoriasis, the greater the risk of myocardial infarction (MI).”

Protecting Your Heart
The good news is that treating your psoriasis may actually help your heart in more ways than one. “There is exciting new information that TNF alpha inhibitors like Enbrel and Humira, both used to treat psoriasis, have been shown to decrease atherosclerosis and the incidence of MI and stroke,” adds Dr. Lalak. However, this isn’t true of all psoriasis medications. For example, treatment with steroids may actually increase your risk of heart problems, so it’s best to talk to your doctor about your treatment options.

According to Dr. Krasuski, patients with psoriasis need to address CAD risk factors. “If you smoke, you should be strongly encouraged to quit,” he says. “Have your cholesterol checked, and if your LDL is elevated, I would recommend treatment with a statin. Similarly, if your blood pressure is elevated, it should be appropriately treated with dietary salt restrictions and medications.”

Losing weight is important as well. Dr. Krasuski states that all patients with an inflammatory disorder (like psoriasis) should be encouraged to try to stay active, exercise, and eat a healthy diet. “This is sound advice for any patient at considerable risk for cardiovascular disease,” he adds.