Study shows chronic skin ailment psoriasis may raise heart disease risk

Patients with psoriasis — a chronic systemic immune-mediated inflammatory disease — could be at higher risk for cardiovascular disease, a new study has found. 

While psoriasis affects 1-3 per cent of the global population, cardiovascular diseases like heart attack and stroke are the leading cause of death globally. 

Researchers from the University of Padova in Italy conducted a study on 503 psoriasis patients without clinical cardiovascular disease, who underwent transthoracic doppler echocardiography to evaluate coronary microcirculation.

They found a high prevalence of coronary microvascular dysfunction in more than 30 per cent of asymptomatic patients.

"Previous studies have shown that patients with severe psoriasis have an increased cardiovascular morbidity and mortality. However, there has been limited research on the specific mechanisms underlying this increased risk, particularly regarding coronary microvascular dysfunction,” said lead investigator of the study, Stefano Piaserico, dermatology unit, department of medicine, at the university.

The results have been published in the Journal of Investigative Dermatology.

The study also revealed that psoriasis severity — assessed by the Psoriasis Area Severity Index (PASI) score — and the duration of the disease are independently associated with lower coronary flow reserve (CFR), along with the presence of psoriatic arthritis.

Furthermore, conventional cardiovascular risk factors, such as tobacco use, hyperlipidemia, and diabetes mellitus, were not independently associated with reduced CFR in patients with severe psoriasis.

"We should diagnose and actively search for microvascular dysfunction in patients with psoriasis, as this population is at particularly high risk,” said Piaserico.

“We might hypothesise that an early and effective treatment of psoriasis would restore the dysfunction and eventually prevent the future risk of myocardial infarction and heart failure associated with it," Piaserico added.