Psoriasis and cardiovascular risk. Is there any association?

Abstract

We have recently read a very interesting article by Branisteanu et al. [1], describing the association between psoriasis and increased cardiovascular risk (CVR). We believe this article raises an important issue and the dissemination of knowledge about the relationship between these two diseases may promote prevention and earlier diagnosis of cardiovascular diseases (CVD). Psoriasis is a chronic, papulosquamous skin disorder characterized by chronic inflammation, affecting 3-5% of the general population worldwide [1]. Individuals with psoriasis are at increased risk of hypertension, cardiovascular disease, dyslipidaemia, obesity and diabetes [2]. Research is being conducted to understand the molecular mechanisms between the development of psoriasis and its comorbidities. Recent studies have identified that psoriasis and CVD have various common pathogenic pathways including genetic factors, inflammatory pathways, adipokine secretion, insulin resistance, lipoproteins, angiogenesis and oxidative stress [3]. Reasons for increased CVD risk include both increased systemic inflammation caused by psoriatic lesions, usually covering large areas of the skin and the fact that psoriasis is associated with an increased incidence of modifiable cardiovascular risk factors such as obesity, smoking, hypertension, diabetes mellitus, dyslipidemia, metabolic syndrome and a sedentary lifestyle [3]. The study by Karbach et al. [4] found that psoriatic patients with heart attacks were on average 5 years younger than heart attack patients without psoriasis. Conversely, the study showed lower in-hospital mortality in psoriatic patients with myocardial infarction, probably caused by lower age [4].