Heart disease more likely in people with psoriasis

NEW YORK Tue Jan 10, 2012 4:16pm EST

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NEW YORK (Reuters Health) - People who suffer from psoriasis may want to pay extra attention to heart risks, according to a new study that found they are at a greater risk for blocked arteries than those who don't have the skin disease.

The study, published in the American Journal of Cardiology, also suggests the heart risks are higher in people who've had psoriasis longer.

"Our advice to patients with psoriasis is to make sure they get screened for their modifiable cardiovascular risk factors," said Dr. Joel Gelfand, a professor of dermatology at the University of Pennsylvania, Philadelphia.

According to Gelfand, who was not involved with the current study, those risk factors include smoking, a person's blood pressure, cholesterol, glucose levels and body mass index (BMI), a measure of weight relative to height.

Researchers used records of patients who had undergone a heart scan called coronary angiography to compare the results of patients with and without psoriasis.

Among the nearly 9,500 patients included in the analysis, just over 200 were diagnosed with psoriasis. Compared to the other patients who underwent the heart screening, they were more likely to have a history of high cholesterol and be heavier.

Overall, 84 percent of patients with psoriasis had narrowing of the arteries that supply blood to the heart -- a condition called coronary artery disease -- compared to 75 percent of patients without the skin condition.

The researchers also found that patients had a higher risk of heart disease the longer they'd had psoriasis.

"One of the things that we've come to understand is that psoriasis is not a disease that's just limited to the skin," said Dr. April Armstrong of the University of California, Davis, who worked on the new study.

People with psoriasis have patches of thick, red and scaly skin, which are thought to be caused by the immune system mistakenly attacking the body's own cells.

According to the National Psoriasis Foundation, about 7.5 million Americans have psoriasis.

Although the study doesn't prove the condition causes heart disease, Armstrong told Reuters Health that the skin rash may be a sign that there is inflammation inside the body, too.

Dr. Richard Krasuski, director of Adult Congenital Heart Disease Services at the Cleveland Clinic, said the new findings fit with past studies that showed a connection between heart disease and inflammatory diseases such as rheumatoid arthritis.

"Certainly what they come up with makes biological sense," said Krasuski, who was not involved with the study.

But he cautioned that the increase in risk was not overwhelming and the findings are based on patients from only one medical center.

Krasuski said that treatment is usually left to doctors depending on their specialty. So a cardiologist won't treat an inflammatory disease even if it's linked to a heart condition.

Gelfand said patients with psoriasis can be treated a number of ways depending on how severe it is. Treatments can include topical creams, ultraviolet light therapy and oral medications. But he added that light treatments and newer biological medicines can be expensive.

SOURCE: bit.ly/yZsZcO American Journal of Cardiology, online January 3, 2012.

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