It’s never too early to adopt a heart-healthy lifestyle. Eating well, getting plenty of exercise and maintaining a healthy body weight can help reduce the risk of heart disease in people of all ages, including children and adolescents.
According to the latest research, taking early steps to reduce the risk of heart disease may be especially important in kids with psoriasis.
A study published in September in the Journal of Investigative Dermatology found that children with psoriasis may already show early signs of risk factors for future heart disease and diabetes, and should work with their doctor to reduce these risks—and hopefully reverse them, said Dr. Wynnis Tom, a pediatric and adolescent dermatologist at the University of California, San Diego, and the lead author of the study.
The study compared 44 children with psoriasis with 44 children without psoriasis, matched for age and sex. The average age of children in the study was 13, with roughly the same number of girls and boys.
On average, psoriasis patients had the disease for about five years; 25 percent had mild psoriasis, 36 percent were moderate, and 39 percent had severe disease, according to the data.
Researchers tested the kids’ cholesterol to determine whether there was a profile that was riskier for future heart disease and diabetes risk among the psoriasis patients compared to those without psoriasis. Although levels of high-density lipoprotein (HDL) and low-density lipoprotein (LDL) cholesterol seemed normal in psoriasis patients, researchers found important differences when they performed more advanced characterization of the lipids, said Tom.
These advanced tests measured the number of particles that carry cholesterol, along with the way those particles work in the body. Abnormalities were found that indicated that kids with psoriasis might be at higher risk for heart disease in the future, if not corrected over time, said Tom.
For instance, compared to kids without psoriasis, the psoriasis patients had decreased cholesterol efflux capacity, which measures the ability of HDL cholesterol particles—what’s known as the “good” cholesterol—to clear cholesterol located at other sites of the body, such as cholesterol lining blood vessels.
In addition, kids with psoriasis showed more signs of insulin resistance—a risk factor for type 2 diabetes—than the kids without psoriasis.
The study also found higher rates of being overweight and obese among psoriasis patients, said Tom. However, even with obesity taken into account, the study found that psoriasis itself still had an adverse impact on cardiometabolic risk, she noted.
Physicians and families can work together to protect kids’ health
Doctors have known for some time that adults with psoriasis have an increased risk for issues like cardiovascular disease, diabetes and obesity. But the researchers were surprised to find that signs of increased risk started so early in psoriasis in a young patient population, said Dr. Nehal Mehta, a member of the National Psoriasis Foundation Medical Board and senior author of the study from the National Heart, Lung and Blood Institute.
“Looking for these abnormalities early in the disease is important, and now we have preliminary evidence that we need to evaluate children with psoriasis more systematically,” said Mehta.
Being careful to minimize cardiovascular risk is something all children should do, said Tom. Having psoriasis is an added reason to be extra conscious of things like body weight, diet and exercise, and having regular visits with the pediatrician, she noted.
Tom and her colleagues are working to develop guidelines on how best to screen for cardiometabolic issues in children with psoriasis.
In the meantime, said Mehta, pediatric patients and their families need to be aware of the risk and monitor their heart health. “This is a family effort to maintain a healthy diet and active lifestyle,” he said. “We are encouraged that these lifestyle changes can stop or even reverse some of these metabolic disturbances.”
All patients with psoriasis should have their blood pressure and body mass index checked, as well as have blood tests to check for cholesterol and glucose levels, Mehta said.
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