"In patients under age 50 with severe disease, the risk is comparable to diabetesdiabetes. This is the first study to show this," Joel M. Gelfand, MD, tells WebMD. Gelfand is an assistant professor of dermatology at the University of Pennsylvania School of Medicine.
Gelfand led a team of researchers who compared heart attack risks in almost 131,000 patients with psoriasis; 3,837 of those patients had severe psoriasis. The study also included 556,995 matched patients who did not have psoriasis for comparison.
The researchers found that psoriasis was associated with an elevated risk of heart attack in all age groups, but especially in younger patients with severe disease.
"This is an important finding because psoriasis patients need to be talking to their doctors about this. Likewise, doctors need to be talking to psoriasis patients about this possible risk," says Liz Horn, director of research at the National Psoriasis Foundation.
Gelfand's study appears in the Oct. 11 issue of The Journal of the American Medical Association.
Study Builds on Previous Research
Several smaller, hospital-based studies have shown a link between psoriasis and an increased risk of heart attack. "But none of these studies controlled for age, gender, elevated cholesterol, diabetes, smoking, and other risk factors," Gelfand says. "That's what's novel about our study."
According to the study, excess heart attack risk is higher among psoriasis patients who are younger. For example, a 40-year-old patient with mild disease has a 20% greater risk of heart attack than a 40-year-old patient without psoriasis. But a 40-year-old patient with severe disease has more than double the risk.
The risk appears to decline somewhat in older patients. For example, the study found that a 60-year-old patient with severe disease has a 36% higher risk than a 60-year-old patient without psoriasis.
"The absolute risk is still low, even for someone who has severe disease," Gelfand says. "If you're in your 40s or 50s, your risk of having a heart attack each year due to psoriasis is about one in 400 to one in 600. Over 10 years, that adds up to about one in 40-60. So it does become a significant risk factor over time."