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The Link between
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The Link between Psoriasis and Coronary Artery Disease
By Richard Shank
Editors at the American Journal of Cardiology recently issued a consensus statement regarding the need to recognize the link between psoriasis and Coronary Artery Disease (CAD).
Psoriasis is a common disease that affects 125 million people worldwide. Nearly 80% of psoriasis patients report that it has a negative impact on their lives (e.g. physical symptoms, embarrassing appearance, etc.). The causes of psoriasis are not well understood.
The link between psoriasis and CAD was first documented in 1961. Subsequent research has documented a strong pattern of increased risk of CAD for patients with psoriasis. Five possible mechanisms linking CAD and psoriasis have been suggested:
- CAD and psoriasis may share and increase common risk factors (e.g. smoking and obesity).
- Psoriasis medications increase adverse CAD risk profiles (e.g. high blood pressure).
- Inflammation caused by psoriasis can add stress to the cardiovascular system.
- CAD might be under diagnosed in favor of treating the surface issue of psoriasis.
- Both psoriasis and CAD share genetic profiles.
The editors make a variety of clinical recommendations to health care workers who often see cases of psoriasis. These recommendations are based on specific clinical signs and symptoms, such as mild psoriasis coupled with elevated risk profiles. The recommendations range from information to be provided to at-risk patients (e.g. health information on the link between CAD and psoriasis) to medicinal treatments for severely psoriatic patients with extremely high risk for CAD (e.g. new biologic agents that do not elevate blood pressure).
This consensus statement also raises important issues about the roles of common risk factors in the development of both conditions. They suggest further research focusing on the relationship between inflammation, lifestyle, environment, psoriasis, and CAD.
Source: Friedwald, V., Cather, J., Gelfand, J. 2008. AJC Editor’s Consensus: Psoriasis and Coronary Artery Disease. American Journal of Cardiology 102: 1631-1643.
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