The association of psoriasis and hypertension: focusing on anti‐inflammatory therapies and immunological mechanisms

Abstract

Summary Psoriasis is a chronic skin disease characterized by recurrent inflammation, and is increasingly being recognized as a systemic inflammatory disorder, which is associated with cardiovascular events, metabolic syndrome, diabetes, obesity and hypertension. Recent findings have suggested a greater risk of hypertension, particularly difficult‐to‐control hypertension, in patients with severe psoriasis. Additionally, abnormal activation of immune cells with overexpression of pathogenic cytokines in psoriasis, leading to immune cascade, oxidative injury and collagen deposition in arteries, may further contribute to vascular stiffening and hypertension. However, studies have demonstrated beneficial effects of antipsoriatic drugs on blood pressure and the cardiovascular system, including immunosuppressants and biological reagents targeting tumour necrosis factor‐α, interleukin (IL)‐17A and the IL‐12/23 p40 subunit. This review summarizes the mechanisms underlying the impact of systemic inflammation on skin and arteries, and assesses the epidemiological and clinical links between psoriasis and hypertension.

Cardiovascular Disease-Associated Skin Conditions

“…10 Both psoriasis and psoriatic arthritis are linked to CVR and CVE through three main elements: a chronic inflammatory state that stimulates atheroma plaque formation, 11 typical serum and local activated pathways, 6 and increased traditional and non-traditional CVR factors, all explained below. 12 Psoriasis and psoriatic arthritis are directly related to CVR. 13 Besides unspecific chronic inflammation, the axis IL-12/ Th1 and IL-23/Th17 have been described as part of common immunological mechanisms leading to skin and endovascular plaque formation.…”

“… 10 Both psoriasis and psoriatic arthritis are linked to CVR and CVE through three main elements: a chronic inflammatory state that stimulates atheroma plaque formation, 11 typical serum and local activated pathways, 6 and increased traditional and non-traditional CVR factors, all explained below. 12 …”

Serum concentration of endocan, fetuin-A, and endothelin in plaque psoriasis – coincidence or fate? A preliminary study

“…Dotyczy około 2% populacji ogólnej [1]. Ostatnio wiele dowodów wskazuje, że PV nie jest chorobą ograniczoną wyłącznie do skóry, ale powinna być zaliczana do schorzeń metabolicznych ze względu na jej współistnienie z innymi zaburzeniami, takimi jak nadciśnienie tętnicze [2], niealkoholowe stłuszczenie wątroby [3], cukrzyca [4], otyłość [5] lub hipercholesterolemia [6]. Wskazuje się, że częstsze występowanie zaburzeń metabolicznych współistniejących z PV niż w grupie kontrolnej jest spowodowane ogólnoustrojowym stanem zapalnym, jednak nie udało się dotąd usystematyzować zależności między nimi.…”

“…Dermatology Review/Przegląd Dermatologiczny 2021/1 introduction Psoriasis vulgaris (PV) is one of the most common dermatoses and affects up to 2% of the general population [1]. Much recent evidence has shown that PV is not only limited to the skin, but should be considered as a metabolic disease due to the coexistence with, e.g., hypertension [2], non-alcoholic fatty liver disease [3], diabetes mellitus [4], obesity [5], or hypercholesterolaemia [6]. It has been suggested that increased prevalence of metabolic disturbances coexisting with PV is caused by systemic inflammation; however, no exact connections have been established yet.…”

γδ‐T cells as a potential candidate contributing to the development of psoriatic cardiovascular disease

“…Dear Editor, Psoriasis is an immune-mediated inflammatory skin disease affecting the cardiovascular system. 1 Gamma delta (cd) T cells are found in the skin lesions of patients with psoriasis and in imiquimod (IMQ)-induced psoriasis mouse models, and are associated with the relapse of psoriatic skin. 2 We found that the expression of cd-T cells in patients with psoriasis is negatively correlated with the neutrophil/lymphocyte ratio (NLR), that is related to risk of cardiovascular event (CVE) (Fig.…”