By Lisa Rapaport
(Reuters Health) – People with psoriasis, a chronic inflammatory disease, may be more likely than others to experience heart attacks and strokes at least in part because inflammation damages their vascular system, a recent study suggests.
The longer people had lived with psoriasis, the more inflammation they had in their blood vessels, the analysis of imaging tests for 190 psoriasis patients found.
While these imaging tests didn’t connect vascular inflammation to an increased risk of heart attacks and strokes, researchers also examined data on roughly 87,000 Danish adults with psoriasis and another 4.2 million people without the condition. They found each year people lived with psoriasis was associated with a 1 percent increase in the future risk of cardiovascular events like heart attacks and strokes.
“It has been suspected that long-term exposure to low-grade systemic inflammation may increase the risk of cardiovascular events, but the effect of disease duration on the relationship between psoriasis and cardiovascular disease has been unclear,” said lead study author Dr. Alexander Egeberg of Gentofte Hospital in Copenhagen.
The inflammation in psoriasis is very similar to, and in many cases can overlap with, the inflammatory processes that contribute to hardening of the arteries, or atherosclerosis, Egeberg said.
Even though plenty of previous research has linked psoriasis to heart disease, the current results offer fresh evidence that living longer with systemic inflammation can increase the risk of heart attacks and strokes even for psoriasis patients who don’t have other risk factors for heart disease such as smoking, diabetes or advanced age, Egeberg added.
All of the patients in the imaging portion of the study had mild to moderate psoriasis.
On average, they were around 54 years old and had been living with psoriasis for roughly eight years.
The duration of psoriasis was associated with increased vascular inflammation even after accounting for traditional risk factors for cardiovascular disease such as smoking and a family history of heart attack or stroke.
In the separate analysis of the Danish population, researchers followed people for an average of almost five years.
During this period, 152,122 people without psoriasis had major events like a heart attack or stroke, which translates into about 8 people out of every 1,000 in the population each year.
Over that same time, 4,472 people with psoriasis had major events like a heart attack or stroke, which translates into about 11 people out of every 1,000 in the population each year.
One limitation of the study is that researchers lacked data for the Danish population on other factors that influence cardiovascular health such as obesity and exercise habits, the authors note in the Journal of the American Academy of Dermatology.
Even so, patients should be aware that psoriasis can make cardiovascular problems more likely, said Dr. Lawrence Eichenfield of Rady Children’s Hospital and the University of California, San Diego.
“There is some evidence that certain systemic medications that treat psoriasis potentially decrease the inflammation and can decrease the psoriasis-associated cardiovascular risks,” Eichenfield, who wasn’t involved in the study, said by email. “The psoriasis treatment options should be discussed with a dermatologist.”
SOURCE: http://bit.ly/2fAzyPm Journal of the American Academy of Dermatology, online August 18, 2017.