Psoriasis And Heart Disease: What Latest Research Says

Is there a known link between psoriasis and heart disease?

This is still a debatable topic in psoriasis medical circles but here are some interesting summaries of clinical studies to understand the current view.

Study Number 1: Psoriasis, psoriatic arthritis and cardiovascular risk: are we closer to a clinical recommendation? 

According to this study, it showed associations between psoriasis, psoriatic arthritis (PsA), rheumatoid arthritis (RA) and an increased risk of major adverse cardiovascular events (MACE—myocardial infarction, stroke and cardiovascular death) in data derived from the UK primary care registry. The results were determined and classed by use of disease-modifying antirheumatic drugs (DMARDs).

They concluded that there is a 1.5 times increase in RA patients chances of serious heart disease. They also suggest that psoriasis sufferers who take DMARDs “may” also be at a higher risk but more clinical study is required. This implies that there may be a link between severe psoriasis and heart disease as only severe cases of psoriasis are treated with DMARDs such as Methotrexate.

They found no correlation for increased risk of serious heart disease for mild to moderate psoriasis sufferers or psoriatic arthritis patients.

This study makes sense in my eyes as when you are suffering from a severe bout of psoriasis, it is usually during a time of high stress, a weakened immune system and a lifestyle that would be deemed unhealthy by most medical professionals. Therefore, in this state, you are increasing the risk factors of a heart attack as well as prolonging the severe psoriasis outbreak.

Study Number 2 & 3 Association Between Skin and Aortic Vascular Inflammation in Patients With Psoriasis

Treatment of psoriasis also reduces vascular information

Two recent studies funded by the National Heart, Lung, and Blood Institute (NHLBI) gave a new way of looking at the link between aggressive treatment of psoriasis with a reduced risk of heart disease.

The study was published in JAMA Cardiology and the aim of the study was to see if treating psoriasis could lead to improvement in vascular inflammation.

The study group consisted of 115 psoriasis sufferers and the treatments used consisted of anti-inflammatory approaches such as medication and light therapy. After 1 year of treatment, the majority of the study group recorded a 33% decrease in their psoriasis inflammation severity and a six percent reduction in inflammation of their coronary arteries. Some of the study group recorded a 75% reduction in their psoriasis and a 11 percent reduction in artery inflammation.

“All types of treatments for psoriasis were included, which suggests that treating the disease itself may impart benefit beyond the skin,” Nehal N. Mehta, M.D., a preventive cardiologist and chief of the Section of Inflammation and Cardiometabolic Diseases at NHLBI said.

Does Psoriasis directly affect coronary arteries

In the second journal study, published in Circulation, by Dr. Mehta’s team, they looked at whether psoriasis directly affected the coronary arteries.

They found evidence that psoriasis patients have higher levels of a dangerous type of coronary-artery plaque associated with heart attacks when compared to a group of patients without psoriasis of a similar age and gender.  These higher plaque levels showed up in the psoriasis patients, regardless of the severity of their condition, the researchers said.

They also noted that when compared to non-psoriasis patients who were 10 years older and had high blood cholesterol, the patients with psoriasis still showed higher levels of this plaque, which can rupture and increase the likelihood of a heart attack.

As with the previous study, they also found that patients who reduced the severity of their psoriasis, also saw a decrease in coronary plaque.

“These findings suggest that treating the skin of psoriasis patients may improve the health of the underlying blood vessels and thereby reduce the risk of heart disease,” Mehta said.

“Importantly, patients with psoriasis should be aggressively screened for cardiovascular risk factors and should be educated about their elevated cardiovascular risk.”

As these were early clinical findings using a small sample size, Dr Mehta made clear that further clinical trials were required to confirm these findings. More specifically, what exact mechanisms change in the body linking skin inflammation and coronary artery plaque measurements.

What To Take From These Studies?

This post was not meant to scare you into worrying about heart disease, however, it is not something that you can just ignore. Heart attacks are the single biggest killer in the Western World and everyone should take the extra effort to look after yourself.

As we have unfortunately triggered our psoriasis gene, we have to work with what we got and this means we have a slightly higher chance of heart disease IF we do not look after ourselves.

The studies above also showed that by reducing our psoriasis, we also reduce our chances of cardiovascular disease. Therefore it is essential that you get regular check-ups, live a balanced lifestyle and cut out all the bad habits that are known as the leading risk factors (see below for full list).

Heart Problems and Psoriasis: FAQs

Heart disease, also known as cardiovascular disease is a medical diagnosis that refers to various conditions related to the heart, and all blood vessels that carry blood throughout the body.

Psoriasis is an autoimmune inflammatory skin condition that is characterised by plaques.

Coronary artery disease (CAD)

Coronary artery disease abbreviated as CAD is one of the most common types of heart disease in the United States. It is linked to a condition called atherosclerosis- the build-up of plaque in the arteries. Arteries are the vessels that carry blood to the heart and other parts of the body.

When psoriasis plaques build up in the arteries, they cause the blood vessels to become too narrow, preventing the sufficient flow of blood into the body. When the vessels leading to the heart become utterly blocked by plaque, it can cause a heart attack. Most people with the coronary artery disease are not aware that they have the condition until a heart attack strikes. If you notice any of these symptoms, seek medical attention immediately:

  • Discomfort or pain in the chest
  • Ache or pain in the neck, back or jaw
  • Discomfort or pain in your arms or shoulder
  • Lightheadedness, weakness or a faint feeling
  • Shortness of breath

Peripheral arterial disease

The peripheral arterial disease, also known as PAD is a condition where the arteries carrying blood to the limbs become narrowed due to a buildup of plaque. This condition is also caused by atherosclerosis. When your arteries become partly or wholly blocked, they prevent blood and oxygen from getting to your arms and legs. Some of the symptoms of PAD to look out for include pain, swelling, numbness in your legs, ankles, and feet.

Stroke

This is another condition that can be caused by the narrowing or blocking of arteries by plaques. When the blocked artery carries blood to your brain, this creates a sudden loss of oxygen and blood. If you notice any of these symptoms, you need to seek medical care immediately:

  • A headache
  • Trouble walking
  • Numbness or inability to move your face, arms or legs
  • Difficulty seeing or speaking

High blood pressure

Blood pressure is the force of blood as it pushes against the walls of your vessels every time your heart pumps. High blood pressure occurs when the blood pressure rises and stays high instead of dropping back down as it should. If not treated, high blood pressure may cause serious problems such as heart failure and stroke.

Irregular heartbeat

Also known as arrhythmia, irregular heartbeat refers to a pulse that is either too fast or too slow. When your heartbeat is irregular, it means that the heart muscle is not pushing blood through your body as it should.

How can you minimise your risk factors?

Diet and Nutrition

A healthy diet helps to control your weight, cholesterol and blood sugar levels. This may be beneficial to improving your heart health as well as lessen the severity of your psoriasis.

Exercise

Regular exercise and an active lifestyle help to increase your heart health as well as improve pain and function. It also reduces the risks of heart disease by nearly a half.

Stress

Stress and anxiety present double trouble for people suffering from psoriasis. Not only does it increase your risk of cardiovascular disease, but also flares up your psoriasis. Engaging in physical activities can help ease physical and mental tension efficiently.

Omega -3 Fatty Acids

These fatty acids are particularly beneficial to people with psoriasis and those who have an increased risk of developing heart disease. Omega 3 fatty acids help to lower your cholesterol and triglyceride levels, which means that your arteries are less likely to amass plaques that lead to heart disease. Since your body cannot make the essential nutrients, you need to get them through your diet.

You can get these essential oils in fatty fish such as:

  • Tuna
  • Sardines
  • Salmon
  • Mackerel

You can also get the nutrients from plant food sources like:

  • Flaxseeds
  • Chia seeds
  • Leafy vegetables
  • Raspberries

You can also add Omega 3 by taking supplements.

Smoking

Smoking damages blood vessels all around your body, thereby increasing the risk of heart disease. It also increases your chances of developing different types of cancer. Therefore, you should stop smoking immediately to reduce your risk of developing heart disease.

Excessive Alcohol Consumption

While there is some evidence that shows moderate consumption of alcohol, particularly red wine, may be useful for your heart, excessive alcohol consumption can lead to various health problems, including heart disease.

What other conditions is Psoriasis associated with?

The medical conditions associated with psoriasis do not end there. Various studies show that psoriasis is associated with an increased risk of cancer, including prostate cancer, skin cancer, and lymphoma. Other researchers also indicate that obesity, depression, Crohn’s disease, diabetes, sexual dysfunction, arthritis, and chronic obstructive pulmonary disease (COPD) are also linked to psoriasis.

Impact of biologics

The use of antibody-based treatments for treating psoriasis helps to suppress the immune system, which plays a central role in psoriasis. Biologics can improve the symptoms of psoriasis- associated arthritis. However, the use of biologics can have severe side effects as it leaves the door open for other infections ranging from common cold to more severe and potentially fatal –fungal infections.

When should you see your Doctor

It is crucial that you consult your health professional if you have any questions regarding your chronic skin condition or heart disease. Also, if you have psoriasis, you need to be up-to-date about the risk factors. The best way to do this is by being aware of the various signs of a looming heart attack. Some of these symptoms include:

  • Fatigue
  • Chest Pain
  • Shortness of breath
  • Pain in your arms
  • Pain in your jaw and neck area
John Redfern