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- Researchers report that psoriasis is associated with an increased risk of heart disease.
- Inflammation is said to be involved in this, but the exact mechanism is unknown.
- Early intervention and effective treatment plans may help reduce cardiovascular risk.
Globally, psoriasis has an estimated impact on:
Despite its prevalence, this immune-mediated skin disease remains a mystery.
Apart from psoriatic lesions on the skin, this condition can also affect less visible parts of the body.
One important example is the association with increased risk of:
Today’s medical news We spoke to Dr. Joel Gelfand, a professor of dermatology and epidemiology at the Perelman School of Medicine at the University of Pennsylvania, about this disease.
“There are many lifestyle, genetic, and immunological links between psoriasis and cardiovascular disease,” he explained.
He noted that scientists have known about this connection for many years and it is an important area of research.
“The more widespread psoriasis is on the skin, the more the patient is at risk for heart attack, stroke and death,” said Gelfand, who was not involved in the study. “Traditional cardiovascular risk factors that are underdiagnosed and undertreated in patients with psoriasis are also important in mediating this relationship.”
In recent research, Journal of Research Dermatologyis using a new approach to study the precise mechanisms behind psoriasis and cardiovascular disease.
Experts say the inflammation associated with psoriasis promotes the development of cardiovascular disease.
This inflammation promotes the growth of plaque within blood vessels and can lead to atherosclerosis, a risk factor for cardiovascular disease.
This includes an increased risk of coronary artery disease, which narrows the blood vessels that supply blood to the heart.
However, there are still some gaps in our understanding. Studies have shown that people with psoriasis have increased cardiovascular risk before coronary artery disease develops.
Some scientists believe this may be due to coronary microvascular dysfunction (CMD). The latest research examines this theory in more detail.
CMD affects the small blood vessels that supply blood to the heart muscle. Like coronary artery disease,
However, the authors of a recent paper say that although coronary artery disease and CMD are related, “they may play distinct roles in the development of vascular disease.”
Some existing evidence suggests that increased cardiovascular risk in psoriasis patients may be due to CMD, but previous studies have been small.
The latest study aims to replicate these findings in a larger group.
Because CMD affects the smallest blood vessels, most standard medical procedures cannot detect CMD. So in this study, the researchers used a measure called coronary flow reserve that can detect both coronary artery disease and CMD.
Coronary flow reserve is a measure of how much blood flow to the coronary arteries can increase during exercise. In other words, assess how much the coronary circulation can expand to increase its volume.
Coronary blood flow reserve in a healthy person is between 3 and 6. A score of 3 means he can triple the blood flow if needed.
A score of 2.5 or less indicates either CMD or coronary artery disease. Therefore, if routine coronary angiography does not reveal coronary artery disease, CMD is suspected.
The researchers included data from 448 patients with psoriasis.
Of these, 31% had a coronary flow reserve of 2.5 or less, but no signs of coronary artery disease were found on follow-up. That means approximately 1 in 3 of her children had CMD.
Compared to participants without CMD, participants with CMD were more likely to:
They were also more likely to have more severe psoriasis and live with the condition longer. Therefore, as the duration and severity of the disease increased, the risk of CMD also increased.
Researchers say the results show that disease duration and severity are associated with CMD. This supports the theory that systemic inflammation causes her CMD, as CMD is also prevalent in people with other inflammatory diseases.
Their analysis also found no association between CMD and traditional cardiovascular risk factors such as smoking, blood fat levels, or type 2 diabetes.
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The authors concluded that high levels of CMD “are likely to contribute significantly to increased risk of adverse disease.” [cardiovascular] Outcomes of patients with psoriasis […] independent from traditional [cardiovascular] Risk factor. “
The authors also note that there is research suggesting that psoriasis treatment is associated with reduced CMD levels. With this in mind, they write:
“[W]One might hypothesize that early and effective treatment of psoriasis could reverse CMD and ultimately prevent the risk of future myocardial infarction and associated heart failure.
Gelfand explained that he and his colleagues are also investigating other ways to assess cardiovascular risk in psoriasis patients.
“The risk of future cardiovascular events can be further refined by cardiac imaging tests such as coronary artery calcium scores,” he said. “We are testing a new intensive care coordination model to help psoriasis patients better screen and manage traditional cardiovascular risk factors. Our preliminary
In the future, the use of various scanning and diagnostic techniques may allow us to assess and address cardiac risk earlier in this population.
Inflammation plays an important role in increasing cardiovascular risk, so psoriasis drugs that reduce inflammation may also help reduce this risk.
But as Gelfand said, the evidence is “quite mixed” at this point.
“So far, TNF [tumor necrosis factor] “Inhibitors seem to hold the most promise in reducing cardiovascular risk in psoriasis, but a causal relationship has not been established,” he said.
If you treat your psoriasis symptoms well, you can reduce your risk in other ways as well.
“Improved disease management could change patients’ lives,” said Dr. Axel Svedbom, a researcher at Sweden’s Karolinska Institutet who was not involved in the latest study. Today’s medical news.
“Patients whose psoriasis is well-controlled may experience less social stigma, live healthier lives, and may sleep better by reducing itching. Sleep deprivation “It’s a risk factor for cardiovascular disease,” he said.
“Furthermore, psoriasis is associated with lipid dysfunction, and disease activity can alter functional lipid composition,” he said. Another potential mechanism is tryptophan metabolism, which is thought to be involved in both psoriasis and cardiovascular disease. ”
There is still much to learn about psoriasis. This study adds another piece to the puzzle.
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