Why People with Severe Psoriasis Have a Higher Risk of Heart Disease: A Deep Dive with a Researcher's Perspective

Researchers report Why People with Severe Psoriasis Have a Higher Risk of Heart Disease. Psoriasis, a chronic inflammatory skin condition affecting millions globally, often carries more than just visible skin concerns. Recent research paints a concerning picture, highlighting a link between severe psoriasis and an increased risk of heart disease. While this connection has been suspected for some time, understanding the “why” and taking action are crucial for individuals living with psoriasis and their healthcare providers.

In an interview, 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.

Why People with Severe Psoriasis Have a Higher Risk of Heart Disease | Stock Photo
Why People with Severe Psoriasis Have a Higher Risk of Heart Disease | Stock Photo

“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.

The Fire Within Inflammation’s Dual Role

Both psoriasis and heart disease share a common thread: chronic inflammation. This internal fire, characterized by an overactive immune system, can wreak havoc on different parts of the body. In psoriasis, it triggers the rapid growth of skin cells, leading to the characteristic red, scaly patches. But this inflammatory response doesn’t stop at the skin. It spills over into the blood vessels, promoting the buildup of plaque, a major culprit in heart disease.

Latest Study Findings: Unveiling the Mechanism

A recent study published in the Journal of Investigative Dermatology sheds light on this connection. Globally, psoriasis affects an estimated 125 million people around the world. Researchers compared the blood flow in individuals with severe psoriasis to those without the condition. They found that those with psoriasis had reduced blood flow to the heart, even without any diagnosed cardiovascular disease. This phenomenon, known as coronary microvascular dysfunction (CMD), can significantly increase the risk of heart attacks and other cardiovascular complications.

The researchers included data from 448 people with psoriasis.

Of these, they found that 31% had a coronary flow reserve of 2.5 or lower, but no sign of coronary artery disease in a follow-up scan. So, roughly 1 in 3 had CMD.

Compared with participants without CMD, those with CMD were more likely to:

They were also more likely to have more severe psoriasis and to have lived with the condition for longer. So, as disease duration and severity increased, so did the risk of CMD.

The Numbers Speak: Quantifying the Risk

The link between psoriasis and heart disease isn’t just theoretical. Studies have shown that individuals with psoriasis have a two-fold increased risk of heart attack and stroke compared to the general population. This risk rises even further with severe psoriasis, reaching a four-fold increase. These statistics underscore the importance of early identification and proactive management for individuals with psoriasis.

Studies in the general population and people with psoriasis demonstrate that low coronary flow reserves predict poorer cardiovascular outcomes.

The authors conclude that the high levels of CMD are “likely to contribute significantly to the increased risk of adverse [cardiovascular] outcomes in patients with psoriasis […] independently of traditional [cardiovascular] risk factors.”

The authors also note that some research suggests that treating psoriasis is associated with reduced levels of CMD. With this in mind, they write:

“[W]e might hypothesize that an early and effective treatment of psoriasis would restore a CMD and eventually prevent the future risk of myocardial infarction and heart failure associated with it.”

Beyond the Study: A Broader Perspective

While the recent study provides valuable insights into the biological link between psoriasis and heart disease, it’s crucial to acknowledge that other factors contribute to this increased risk. These include:

  • Lifestyle habits: Smoking, physical inactivity, and unhealthy diet are well-known risk factors for heart disease and can further exacerbate the risks associated with psoriasis.
  • Obesity: Obesity is linked to both psoriasis and heart disease, creating a double whammy effect for individuals with both conditions.
  • Genetic predisposition: Some individuals may have a genetic predisposition to both psoriasis and heart disease, making them more susceptible to the combined risk.

Taking Charge: Proactive Management Strategies

The good news is, that there are steps individuals with psoriasis can take to mitigate their risk of heart disease:

  • Maintaining a healthy weight: Losing excess weight can significantly improve cardiovascular and psoriasis health.
  • Embrace a healthy diet: Choose a diet rich in fruits, vegetables, whole grains, and lean protein while limiting processed foods, sugary drinks, and unhealthy fats.
  • Exercise regularly: Regular physical activity is essential for both heart health and managing psoriasis symptoms. Aim for at least 30 minutes of moderate-intensity exercise most days of the week.
  • Quit smoking: Smoking cessation is one of the most significant steps you can take to improve your heart health and potentially reduce psoriasis flares.
  • Manage stress: Chronic stress can worsen both psoriasis and heart disease. Practice stress-management techniques like yoga, meditation, or deep breathing.
  • Work with your doctor: Regular communication and monitoring with your healthcare provider are crucial. Discuss your heart disease risk and work together to develop a personalized management plan.

Beyond Traditional Screening: Looking Deeper

While traditional methods like cholesterol checks and blood pressure monitoring are essential, additional measures can provide a more comprehensive picture of cardiovascular risk in psoriasis patients. These include:

  • C-reactive protein (CRP) test: This blood test measures inflammation levels, which can be elevated in both psoriasis and individuals at increased risk for heart disease.
  • Carotid intima-media thickness (IMT) test: This test measures the thickness of the lining of the carotid arteries, which can indicate early signs of atherosclerosis.
  • Coronary artery calcium scoring: This test measures the amount of calcium buildup in the coronary arteries, another indicator of increased heart disease risk.

Remember, You’re Not Alone:

Living with psoriasis can be challenging, and the added concern about heart disease can be overwhelming. However, it’s important to remember that you’re not alone. With proactive management, healthy lifestyle choices, and open communication with your doctor, you can significantly reduce your risk and live a healthier, more fulfilling life.

Looking Forward: The Future of Research

Research into the link between psoriasis and heart disease is ongoing, with exciting possibilities on the horizon. Here are some areas of future focus:

  • Developing targeted therapies: Researchers are exploring new drugs and treatments that specifically address the inflammatory pathways common to both psoriasis and heart disease. This holds the potential for personalized medicine, tailoring treatments to individual needs and maximizing effectiveness while minimizing side effects.
  • Unraveling the genetic link: While some genetic predispositions to both psoriasis and heart disease are known, further research is needed to fully understand the complex interplay of genes and environmental factors. This knowledge could pave the way for early identification and preventive strategies for individuals at high risk.
  • Exploring the gut microbiome: Recent studies suggest the gut microbiome, the vast community of bacteria residing in our intestines, might play a role in both psoriasis and heart disease. Understanding these connections could lead to novel microbiome-based interventions for managing both conditions.
  • Improving diagnostic tools: Researchers are developing non-invasive and more accurate methods for assessing cardiovascular risk in individuals with psoriasis. This could include advanced imaging techniques and blood-based biomarkers that provide a more personalized risk assessment.
  • Precision medicine: The future of managing the psoriasis-heart disease connection likely lies in precision medicine. This approach tailors treatment strategies based on an individual’s specific genetic, phenotypic, and environmental factors. By considering the unique profile of each person, healthcare providers can offer more targeted and effective interventions to manage both conditions simultaneously.
  • Collaboration is key: Ultimately, addressing the complex link between psoriasis and heart disease requires collaboration between researchers, dermatologists, cardiologists, and other healthcare professionals. By working together, they can share knowledge, develop innovative treatment strategies, and improve the overall well-being of individuals living with both conditions.

key takeaways:

  • Psoriasis, especially in its severe form, is associated with an increased risk of heart disease.
  • Chronic inflammation plays a key role in both conditions.
  • Lifestyle choices like maintaining a healthy weight, exercising regularly, and eating a balanced diet can significantly reduce your risk.
  • Open communication and collaboration with your healthcare provider are crucial for managing both psoriasis and heart disease.
  • Exciting research is ongoing, offering hope for future advancements in diagnosis, prevention, and treatment.

Remember, hope is on the horizon. Researchers are actively exploring new avenues to understand and prevent the increased risk of heart disease associated with psoriasis. These efforts hold the promise of a future where individuals with psoriasis can live healthier and longer lives, free from the additional burden of cardiovascular complications.

Note: This article is written based on scientific evidence found by the 247newsaroundtheworld.com team. Sources are duly referenced with keywords hyperlinked to source websites and are clickable for reference.