A recent study published in the Journal of Investigative Dermatology has revealed that patients with severe psoriasis are at an increased risk for heart disease. Psoriasis is a chronic autoimmune condition that affects the skin, causing symptoms such as skin rash and eczema.
The study, which is the largest of its kind, aimed to assess the prevalence of reduced coronary flow reserve (CFR) in patients with severe psoriasis without clinical cardiovascular disease. CFR refers to the capacity of the coronary circulation to dilate and increase blood flow in response to increased demand.
The researchers found that 31.5% of the 448 enrolled patients with severe psoriasis showed coronary microvascular dysfunction (CMD), indicated by a CFR of 2.5 or less. None of these patients had coronary artery disease. The severity and duration of psoriasis were independently associated with lower CFR, as well as the presence of psoriatic arthritis.
Interestingly, conventional cardiovascular risk factors such as tobacco use, hyperlipidemia, and diabetes mellitus were not found to be independently associated with reduced CFR in patients with severe psoriasis.
While the study has some limitations, such as a small portion of patients being treated for psoriasis and the use of only transthoracic Doppler echocardiography for assessing CMD, the researchers believe it highlights the potential mechanisms that increase the risk of heart disease in patients with severe psoriasis.
Lead investigator Stefano Piaserico suggests that diagnosing and actively searching for microvascular dysfunction in patients with psoriasis could help identify those at high risk for cardiovascular complications. Early and effective treatment of psoriasis may restore the dysfunction and prevent future heart-related complications.
In conclusion, this study provides valuable insights into the relationship between severe psoriasis and heart disease, emphasizing the importance of monitoring and managing cardiovascular risks in patients with this condition.
Sources:
– Piaserico S, Papadavid E, Cecere A, et al. Coronary microvascular dysfunction in asymptomatic patients with severe psoriasis. Journal of Investigative Dermatology. 2023;20(9).
– New evidence confirms patients with severe psoriasis are at a higher risk for heart disease. EurekAlert! September 20, 2023.
