Psoriasis May Raise Cardiovascular Risks

June 15, 2009 -- People with psoriasis may need to pay close attention to their cardiovascular risks, a new study shows.

The study, which appears in the June issue of Archives of Dermatology, looked at more than 5,700 patients at the Miami VA Medical Center, including 3,236 psoriasis patients. The patients were 68 years old, on average; most were men and were treated as outpatients at any time from 1985 to 2005.

Psoriasis patients were particularly likely to have diabetes, high blood pressure, and poor cholesterol profiles. Those conditions make cardiovascular problems more likely.

But even beyond that, psoriasis still looked risky.

Even after adjusting for traditional risk factors for heart disease, compared to other patients, the psoriasis patients were:

• 78% more likely to be diagnosed with ischemic heart disease (such as heart attack and angina).
• 70% more likely to be diagnosed with stroke.
• Nearly twice as likely to be diagnosed with peripheral arterial disease (plaque buildup in the arteries that bring blood to the limbs and organs other than the heart).
• More than twice as likely to be diagnosed with atherosclerosis (plaque buildup inside the arteries).
• 86% more likely to die of any cause during the course of the study.

The study doesn't prove that psoriasis caused cardiovascular problems. But researcher Robert Kirsner, MD, PhD, says the findings showed psoriasis to be a risk factor.

"The risk was similar to well-known risk factors such as dyslipidemia [poor cholesterol profiles] and smoking," says Kirsner, who is a professor and the vice chair of the dermatology department at the University of Miami Miller School of Medicine.

It's not clear if psoriasis treatment lowers that risk. "We think it does ... but this needs to be confirmed," Kirsner says.

Previous research suggests that having severe psoriasis or having psoriasis for a long time may mean greater cardiovascular risk than having milder psoriasis for a shorter time, Kirsner notes. The new study didn't get into that.

Kirsner's team urges dermatologists to make sure they're familiar with suggested screening for cardiovascular risk factors and recommendations for aspirin use.

Some psoriasis patients only see dermatologists, "and we don't want dermatologists to miss an opportunity to help not just their skin, but their brain, their hearts, and their legs," Kirsner says.