09:25pm Friday 17 November 2017

Severity of skin psoriasis linked to blood vessel inflammation, cardiovascular risk

Study Highlights

  • The amount of psoriasis a person has on their skin may be related to the amount of inflammation in their blood vessels.
  • Increased blood vessel inflammation may contribute to increased risk of heart attack and stroke. 

DALLAS  — People with more psoriasis may also have more inflammation in their blood vessels, according to research published in the American Heart Association journal Arteriosclerosis, Thrombosis and Vascular Biology.

Psoriasis is a chronic inflammatory disease affecting about 3 percent of U.S. adults. It occurs when skin cells grow too quickly, resulting in thick white or red patches of skin.

Previous research suggests psoriasis may be linked with a higher risk of cardiac events and cardiovascular-related death. This may be the first study to examine whether psoriasis severity impacts inflammation in the blood vessels.

In the study, researchers analyzed 60 adults (average age 47) with psoriasis and 20 (average age 41) without psoriasis. All study participants were at low risk for cardiovascular disease based on a traditional risk assessment. They underwent a nuclear scan that measured blood vessel inflammation, and a dermatologist assessed the amount of psoriasis.

Researchers found:

  • Patients had psoriasis ranging from mild (only a few patches, less than 3 percent of the skin surface affected) to severe (when patches cover more than 10 percent of the skin surface).
  • Patients had high levels of inflammation in their blood vessels — even though they were at low risk for cardiovascular disease.
  • The most extensive forms of psoriasis were associated with a 51 percent increase in blood vessel inflammation.
  • The relationship between psoriasis and increased blood vessel inflammation didn’t change much after accounting for other heart disease risk factors.

“The most important observation we made was that the more psoriasis was on the skin, the more inflammation there was in the blood vessels,” said senior study author Nehal N. Mehta, M.D., M.S.C.E., a Lasker clinical investigator in the Cardiovascular and Pulmonary Branch of the National Heart, Lung, and Blood Institute in Bethesda, Maryland. “In other words, what we see on the outside is mirrored on the inside.”

The findings support the idea that the skin disease and cardiovascular disease may share an immune-related underlying mechanism, but doesn’t prove one causes the other.

“People who have psoriasis — particularly if it is severe — should be assessed by their doctor for cardiovascular risk factors, including diabetes, high cholesterol and obesity,” Mehta said. “They should also maintain an active lifestyle, avoid smoking and follow a balanced diet.”

Co-authors are Haley B. Naik, M.D., M.H.Sc.; Balaji Natarajan, M.D.; Elena Stansky, B.S.; Mark A. Ahlman, M.D.; Heather Teague, Ph.D.; Taufiq Salahuddin, B.S.; Qimin Ng, B.S.; Aditya A. Joshi, M.D.; Parasuram Krishnamoorthy, M.D.; Jenny Dave, M.S.; Shawn M. Rose, M.D., Ph.D.; Julia Doveikis, B.S.; Martin P. Playford, Ph.D.; Ronald B. Prussick, M.D.; Alison Ehrlich, M.D.; Mariana J. Kaplan, M.D.; Benjamin N. Lockshin, M.D.; and Joel M. Gelfand, M.D., M.S.C.E.

The NHLBI Intramural Research Program and National Psoriasis Foundation funded the study.

Additional Resources:

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