In an ideal world, a blood pressure test would be performed not only during regular physical checkups at your general practitioner's office, but during your dermatologist visits as well.
So says cardiologist David Frid, M.D., of the Cleveland Clinic, who believes taking such action is wise given the link between high blood pressure and psoriasis.
"It's not difficult to do a blood pressure check—it's an easy test to perform," Frid said. "I think it depends upon the comfort level of your dermatologist, but it might be beneficial for them to consider blood pressure screenings during office visits. So if it is elevated, they can refer you back to your primary care physician. At a minimum, they should be saying to you that there is this relationship between high blood pressure and having psoriasis."
Emerging research reveals that people with psoriasis are at risk for developing other serious medical conditions. A 2008 report in the Journal of the American Academy of Dermatology cited findings that people with more severe cases of psoriasis appear to have an increased incidence of psoriatic arthritis, cardiovascular disease, hypertension, diabetes, cancer, depression, obesity and even other immune—related conditions such as Crohn's disease.
Indeed, according to a study by the National Psoriasis Foundation of 5,000 people with psoriasis, nearly two—thirds report having at least one other critical health problem. Some 33 percent of these patients reported having high blood pressure, also known as hypertension.
Blood pressure is the measurement of the pressure or force of blood pushing against blood vessel walls. The heart pumps blood into the arteries (blood vessels), which carry the blood throughout the body. High blood pressure, or hypertension, means the pressure in your arteries is above the normal range.
Those traditionally at a higher risk for developing high blood pressure have been African Americans, individuals considered to be obese and those who have a family history of the health condition, Frid said. Blood pressure levels lower than 120/80 are considered normal, Frid said, adding that he expects new guidelines to be revealed within six months to a year.
Cut the salt
One way to keep your blood pressure at normal levels is to reduce your salt intake. So important is this diet choice that some food manufacturers and U.S. cities are pushing for lower salt levels in food. Such pledges are part of the National Salt Reduction Initiative, started by New York City Mayor Michael Bloomberg. It is a coalition of cities and health organizations that aims to reduce salt in restaurant and packaged foods by 25 percent over five years.
You can do your part. Here are three ways to cut back on salt, according to registered dietician Brenda J. Ponichtera, author of "Quick & Healthy Recipes and Ideas" (Small Steps Press, 3rd edition, 2008).
- Don't use salt at the table.
- Use less salt in cooking. A small amount can give enough flavor to help you reduce or eliminate salt at the table.
- Avoid or cut back on processed foods, including canned, convenience and fast foods and snacks. All contain added sodium.
Some other tips from Ponichtera
- Buy fresh or frozen vegetables. Fresh usually taste better and are low in sodium. Most frozen vegetables don't have added salt and taste better than canned.
- Choose no-salt or low-salt canned foods, soups, broth and bouillon.
- Drain and rinse vegetables and beans canned with salt.
- Avoid or limit salted and cured meats such as ham, bacon and luncheon meats.
- Try reduced-salt ham or bacon, which have less sodium than more common varieties.
- Go light on condiments such as ketchup, mustard and steak sauce.
- Add vinegar or a lemon or lime slice to flavor fish and vegetables.
- Use seasoning powders; avoid seasoning salts.
- To add flavor, use herbs and spices, which are not significant sources of sodium.
- Try unsalted snack foods such as baked tortilla chips and popcorn; look for whole-grain crackers with unsalted tops.
- Order hamburgers without pickles and cheese and french fries without salt.
"I think there will be some changes, though I don't think they'll be major changes," he said. "We're trying to be more aggressive in regards to getting people diagnosed and treated earlier."
Making lifestyle changes—eating healthful foods, losing weight and exercising—is the first line of defense against high blood pressure, Frid said. If these don't help significantly, medication may be prescribed. Taking more immediate action sometimes is necessary given that high blood pressure has been called "the silent killer."
"It depends upon how high the blood pressure is and if there are any symptoms of high blood pressure," he said. "Often we will decide to treat somebody without waiting to see about the (effects of) lifestyle changes if someone is having headaches or other symptoms we can attribute to high blood pressure.
"Most people don't know they have it," Frid added. "It's been called the silent killer because people often don't know they have high blood pressure until it's too late. They may have a stroke or a heart attack. They might develop kidney failure or heart failure. That's why there are big recommendations for checking blood pressure on a regular basis by a physician."
Taking good care of your health and sharing any concerns you may have with both your primary physician and your dermatologist are important steps in keeping tabs on potential conditions you may face as a psoriasis patient. Also understanding blood pressure levels and their significance is good to know, Frid said.
"You just need to be aware that we do measure two different values—the top number is systolic, when the heart is pumping out the blood and when the heart is working the hardest, and the bottom number is diastolic, which is when the heart is relaxed," Frid said. "Both of those numbers are important together and also important separately. People can have high blood pressure with one or both numbers."