Patients with psoriatic arthritis (PsA) are at higher risk of having metabolic syndrome than those with psoriasis alone or rheumatoid arthritis, according to a systematic review and meta-analysis published online in the International Journal of Rheumatic Diseases.  Given the association of metabolic syndrome with elevated cardiovascular risk, this should be something that providers assess, the authors of the study wrote.
Metabolic syndrome consists of a group of conditions that put individuals at higher risk for heart disease and diabetes. It includes high blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol or triglyceride levels.  Metabolic syndrome has been associated with systemic inflammation, and in patients with PsA, these conditions have been further linked to difficulty in attaining minimal disease activity. According to the Journal of Rheumatology, “A state of minimal disease activity has been established and is defined by low activity assessed by tender/swollen joint counts, tender entheseal points [the places where tendons and ligaments attach to the bone], Psoriasis Area and Severity Index or body surface area, patient pain and global activity visual analog scale, and functional evaluation by Health Assessment Questionnaire.” 
More than 10% of patients newly diagnosed with PsA develop heart disease within 10 years of developing new-onset inflammatory arthritis, the authors wrote. Patients with PsA also are more likely to die from heart disease.
In their systematic review, the researchers examined cross-sectional studies, randomized controlled trials, cohort studies, and case-control studies published between January 1990 and August 19, 2019, found in peer reviewed literature databases: MEDLINE, PubMed, EMBASE, Google Scholar, ProQuest, Ebsco CINAHL, Scopus, Science Direct, Web of Science, and the Cochrane Library. They excluded studies with 20 or fewer patients. After screening, the final analysis included 24 studies in patients with PsA, 89 in patients with psoriasis and 53 in patients with rheumatoid arthritis.