Psoriasis and Cardiovascular Disease
Well-established comorbidities of psoriasis include:1-11
- Heart attack, stroke, CV death
- Metabolic syndrome (obesity, insulin resistance, cholesterol abnormalities, and hypertension)
- Psoriatic arthritis
- Mood disorders (anxiety, depression, and suicide)
- Crohn’s disease
- T-cell lymphoma (rare)
There is risk of cardiovascular/cardiometabolic disease in patients with more severe psoriasis:1,2,10,12,13
- With psoriasis, there is an increased risk of MI, stroke, cardiovascular death, diabetes, and chronic kidney disease.
- Data suggest an average of 5 years of life lost due to this comorbidity.
- The 10-year risk of major CV event attributable to psoriasis is 6%.
- Patients treated for severe psoriasis are 30 times more likely to experience major adverse cardiovascular events (attributable to psoriasis) than to develop a melanoma.
Standard screening recommendations for cardiovascular disease in patients with psoriasis include:14-16
- Age 18–39 years, no risk factors and BP <130/85 mmHg: every 3–5 years
- Age ≥40 and those at increased risk for high BP (BP 130–139/85–89 mmHg, overweight/obese, African Americans): yearly
- Diabetes (fasting plasma glucose, HbA1c, or OGTT):
- Adults age 40–70 years with BMI ≥25
- Repeat every 3 years
- Cardiovascular risk assessment:
- Traditional risk factors every 4–6 years in patients age 20–79 years
- Estimate 10-year risk in those age 40–79 years
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- Gelfand JM et al. J Invest Dermatol. 2006;126:2194-2201.
- Langan SM et al. J Invest Dermatol. 2012; 132:556-562.
- Kurd SK et al. Arch Dermatol. 2010;146:891-895.
- Armstrong AW et al. J Hypertens. 2013;31:433-442.
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- Li W et al. Am J Epidemiol. 2012;175:402-413.
- Yeung H et al. JAMA Dermatol. 2013;149:1173-1179.
- Mehta NN et al. Eur Heart J. 2010;31:1000-1006.
- Najarian DJ, Gottlieb AB. J Am Acad Dermatol. 2003;48:805-821.
- Mehta NN et al. Am J Med. 2011;124:775.e1-6.
- Wan J et al. 2013;347:f5961.
- Siu AL; USPSTF. Ann Intern Med. 2015;163:778-786.
- Siu AL; USPSTF. Ann Intern Med. 2015;163:861-868.
- Goff DC Jr. et al.. J Am Coll Cardiol. 2014;63:2935-2959.