Psoriasis and Heart Disease: The Hidden Connection
Psoriasis attacks healthy cells, causing inflammation that leads to plaques and other skin changes. Some of the same underlying triggers that drive psoriasis may also pose problems for your heart.
Psoriasis increases inflammation throughout the body, including the cardiovascular system. “Chronic inflammation has long been associated with an increased risk of heart attack and stroke,” says Kevin Campbell, MD, a cardiologist at Health First Medical Group in Melbourne, Florida.
Keep reading to understand the relationship between psoriasis and heart disease.
There is strong evidence linking severe psoriasis with heart disease, but the exact relationship between the two conditions is still unclear. There are several reasons psoriasis may increase the risk of heart disease.
“Psoriasis shares some common factors with heart disease, including genetic relationships”, says Joel Gelfand, MD, director of the Psoriasis and Phototherapy Treatment Center at Penn Medicine in Philadelphia and coauthor of numerous studies on the link between psoriasis and heart disease.
Although this is still an area of active research, some experts believe that both conditions may share inflammatory pathways that drive the progression of heart disease and cause psoriasis plaques.
“Although psoriasis plaques are different from plaques in the arteries, the inflammation that makes the skin red and flaky is a similar kind of inflammation that causes blockages in the arteries,” says Dr. Gelfand. “The more skin that is involved with psoriasis, the higher the risk is of developing diabetes and cardiovascular disease.”
Insulin resistance is when the body doesn’t respond to insulin the way that it should, so it can’t properly process sugar and fats.
The blood sugar buildup caused by insulin resistance can lead to type 2 diabetes, which increases the risk of heart disease.
Psoriasis is linked with abnormal cholesterol and triglycerides, which are types of lipoproteins.
“People with psoriasis have about a 50 percent higher risk of heart attack and stroke, independent of traditional risk factors,” says Gelfand.
Making matters worse, patients with psoriasis are less likely to have these risk factors identified and adequately treated, Gelfand says.
“People with psoriasis that is severe enough to require pills, phototherapy, or biologics have a five-year reduction in life expectancy, the majority of which is due to excess risk of cardiovascular disease,” he says. “And unfortunately, many people with psoriasis are unaware that the connection between the two conditions exists.”
There is some evidence that some medications typically prescribed for moderate to severe psoriasis may improve cardiovascular health.
Medications that may lower the risk of heart attack and stroke include:
TNF inhibitors, such as adalimumab (Humira) are prescribed to treat several inflammatory and autoimmune conditions, including psoriasis. They belong to a group of medicines called biologics.
Ustekinumab (Stelara) is used to treat moderate to severe psoriasis. It works by targeting and blocking the action of interleukin-12 (IL-12) and interleukin-23 (Il-23). Il-12 and IL-23 are both types of cytokines, the chemical messengers produced by cells, and are both involved in psoriasis activity.
While you may not be able to control when you have a psoriasis flare or whether the attack will be mild or severe, there are steps you can take to both manage your psoriasis and protect your heart health.
“If you have psoriasis, you not only need to treat the symptoms of the skin disorder, but also change your lifestyle to adhere to a daily program that will minimize your risk of cardiovascular problems,” says Steven Victor, MD, a dermatologist and the director of Victor Regenerative Medical Centers in New York City and Dubai.
Follow these steps to help you both manage psoriasis symptoms and prevent heart disease.
Effective treatment of psoriasis can help manage skin symptoms and keep inflammation under control.
If you also have high blood pressure, high cholesterol, or diabetes, your doctor may prescribe medications to help manage those conditions to lower the risk of heart disease.
Diet can’t cure or prevent psoriasis, but it can reduce psoriasis symptoms and the risk of comorbidities, including heart disease.
If you’re struggling to quit smoking, you can try nicotine replacement therapy or talk to your doctor about getting help.
“Your healthcare providers are looking out for your best interests. Regular checkups are critical,” says Dr. Victor.
Your doctor can monitor your heart health during regular checkups by taking blood pressure readings and checking your cholesterol and triglyceride levels.
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