Cardiovascular aspects of psoriasis: an updated review

Abstract

Psoriasis, a systemic inflammatory disease, is associated with enhanced atherosclerosis and risk of cardiovascular (CV) disease, which may account for higher morbidity and mortality rates in psoriatic patients. It especially applies to younger psoriatic patients with more severe disease, reducing their life expectancy. The aim of the study was to review the literature on CV disease in psoriasis as well as the pathogenic mechanisms shared between psoriasis and atherosclerosis. Moreover, case-control and cohort studies published between 2006 and 2011 were selected for meta-analysis. The meta-analysis indicates elevated risk of cardiovascular events in psoriatic patients in relation to non-psoriatic controls (OR 1.28; 95% CI 1.18-1.38). It is suggested that the treatment of the inflammatory processes involved in the pathogenesis of both psoriasis and atherosclerosis may be beneficial in reducing the CV risk in psoriatic patients. Further in-depth investigations, including prospective studies, are needed to enable more effective management of psoriatic patients in the future.

Comorbidities in psoriasis

“…They suggested that the treatment of the inflammatory processes involved in the pathogenesis of both psoriasis and atherosclerosis may be beneficial in reducing the CV risk in psoriatic patients. [54] Indian Journal of Dermatology, Venereology, and Leprology | 2013 | Vol 79 | Supplement 1 S16…”

IL-17 Induces Inflammation-Associated Gene Products in Blood Monocytes, and Treatment with Ixekizumab Reduces Their Expression in Psoriasis Patient Blood

“…Past studies in rheumatoid arthritis have shown that systemic immune inhibitors can prevent atherosclerosis and lower the risk for cardiovascular disease (Pietrzak et al, 2013). For instance, tumor necrosis factor blockers, including infliximab, etanercept, and adalimumab, have been found to delay the first cardiovascular event and reduce the incidence of myocardial infarction and cardiovascular-related mortality in rheumatoid arthritis patients (Jacobsson et al, 2005;Dixon et al, 2007;Kerekes et al, 2009).…”

“…The expression of thrombospondin-1, which is involved in the formation of atherosclerotic lesions (Moura et al, 2008), was decreased by 1.56-fold (Po0.05), and genes related to atherosclerosis disease risks and platelet aggregation (e.g., F2RL2) were also suppressed. Cardiovascular disease is one of the most prevalent comorbidities associated with psoriasis (Mehta et al, 2010) and contributes substantially to the morbidity and mortality rates in psoriatic patients (Pietrzak et al, 2013). Recent studies have indicated that IL-17 may be associated with the development of cardiovascular disease and atherosclerosis (Ding et al, 2011;Madhur et al, 2011).…”

A Pattern of comorbidities in psoriasis patients from western India and the relation between disease severity and systemic comoridities: cross sectional study at a tertiary care centre

“…A recent meta-analysis indicates elevated risk of cardiovascular events in psoriatic patients in relation to non-psoriatic controls [9]. Also, Asian-Indians have a higher predisposition to obesity, metabolic syndrome, diabetes, and cardiovascular disorders as compared to western populations.…”