If you have psoriasis, you may already know that you’re at greater risk for heart disease. According to the results of a recent study partly funded by the National Psoriasis Foundation, the risk increases as your psoriasis gets worse.
The study, published today in the Arteriosclerosis, Thrombosis, and Vascular Biology journal, measured vascular inflammation in 60 people with psoriasis. Vascular inflammation is a sign of atherosclerosis—or the hardening of the arteries—and can lead to heart attacks and other cardiovascular problems.
Using a high-tech imaging method that shows what’s going on inside the blood vessels, researchers found that the more severe a patient’s psoriasis was, the more vascular inflammation they had.
As Dr. Nehal Mehta, a member of the NPF Medical Board and senior author of the study, explained, “When one thing goes up, another thing goes up.”
Even a few plaques may increase risk
But this doesn’t mean that people with mild psoriasis were off the hook. In fact, the study involved mostly people with mild to moderate disease, and indicated that even having limited disease in the form of a few psoriasis plaques still puts patients at risk.
“Even patients with mild disease have something brewing in terms of vascular inflammation,” said Dr. Haley Naik, a dermatologist at University of California, San Francisco, and lead author of the study. Naik received a $75,000 NPF Discovery Grant in 2014 that partly funded the study.
Doctors already know that psoriasis and psoriatic arthritis are tied to cardiovascular disease. But this study is a “game changer,” Mehta said, because it shows how important it is for doctors to monitor cardiovascular risk, even in people with mild disease.
“As a dermatologist, it’s important for our community to be proactive about helping patients get assessed for cardiovascular risk factors like diabetes, cholesterol and obesity,” Naik said.
Role of the immune system
Inflammation is the culprit behind many diseases, including autoimmune disorders such as psoriasis and psoriatic arthritis, as well as heart disease. Immune cells and pro-inflammatory proteins can travel throughout the body, leading to inflammation in many different locations, including the skin, joints and blood vessels.
This study discovered that a kind of immune cell called a neutrophil, and a certain protein that neutrophils release, could be a connection between skin and vascular inflammation. Other research has focused on the role of different immune cells and the cytokines, or proinflammatory proteins, they release.
Having just one plaque of psoriasis could be enough to set this inflammatory process in motion, according to Mehta.
“In my opinion, I believe that one plaque should be taken seriously,” Mehta said. “Mild psoriasis may still predispose to proinflammatory cytokines leading to chronic low-grade inflammation,” he said.
How much vascular inflammation mild patients have is the subject of another study Mehta and his colleagues are currently conducting. They are studying people who have less than 5 percent of their bodies covered with psoriasis.
Researchers are also studying whether treating psoriasis with systemic treatments like phototherapy and biologics may also reduce inflammation in the blood vessels.
Steps to improve psoriasis and prevent heart disease
While scientists continue to search for answers, patients can take steps now to improve their psoriasis and prevent heart disease.
“One of the most important things patients can do is see their doctors,” Naik said.
Patients should be sure to stay on top of their psoriasis treatment and get annual physicals in addition to reducing cardiovascular risk through staying active, eating well and avoiding smoking, she added.
Support from NPF
Funding from her NPF Discovery Grant was essential to conducting the study, Naik said. The grant was particularly important for the research on immune system activity, she explained.
“That would have been difficult to do without the support of the Discovery Grant,” she said. The study also provided her with the resources she needed to advance her career as a dermatologist and further her interest in this area of research, she said.
In addition to funding from NPF, this study was also supported by the National Institutes of Health.
Driving discovery, creating community
For more than 50 years, we’ve been driving efforts to cure psoriatic disease and improve the lives of those affected. But there’s still plenty to do! Learn how you can help our advocacy team shape the laws and policies that affect people with psoriasis and psoriatic arthritis – in your state and across the country. Help us raise funds to support research by joining Team NPF, where you can walk, run, cycle, play bingo or create your own fundraising event. If you or someone you love needs free, personalized support for living a healthier life with psoriatic disease, contact our Patient Navigation Center. And keep the National Psoriasis Foundation going strong by making a donation today. Together, we will find a cure.