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| |  Psoriasis Associated With Cardiovascular Disease, Increased Mortality CHICAGO -- June 15, 2009 -- Psoriasis is associated with atherosclerosis characterised by an increased prevalence of ischaemic heart disease, cerebrovascular disease, peripheral artery disease, and an increased risk of death, according to a study published in the June issue of Archives of Dermatology. “More recently, psoriasis has also been shown to be a systemic inflammatory condition, with similarities to other inflammatory immune disorders,” the authors wrote. “Since the risk of myocardial infarction is increased in rheumatoid arthritis and systemic lupus erythematosus, which are both inflammatory conditions, attention has been focused on the association between psoriasis, cardiovascular risk factors and myocardial infarction.” Srjdan Prodanovich, MD, University of Miami Miller School of Medicine, Miami, Florida, and colleagues analysed the computerised records of 3,236 patients with psoriasis and 2,500 individuals without psoriasis who were seen at the same Veterans Administration facility. Patients in the psoriasis group were slightly older than those in the control group without psoriasis (mean age 67.9 vs 65.1) and were more likely to be men (95.5% vs 88.2%). “After age, sex, history of hypertension, diabetes, dyslipidemia, and smoking status were controlled for, patients with psoriasis were significantly more likely than controls to carry a diagnosis of atherosclerosis,” the authors wrote. Patients with psoriasis were also more likely to have an additional diagnosis of another blood vessel disease, including ischaemic heart disease, cerebral vascular disease or peripheral arterial disease. “This result is not surprising, given the systemic nature of atherosclerosis,” the authors wrote. “It has tremendous and far-reaching clinical implications, as all of these vascular conditions represent a major financial cost to the healthcare system as well as a major cause of disability and death.” “The latter finding was corroborated by our analysis, whereby we concluded that psoriasis is an independent risk factor for mortality. We found a higher percentage of deaths among patients with psoriasis than among patients without psoriasis (19.6% vs 9.9%).” Future studies should investigate whether aggressive treatment of either cardiovascular risk factors or psoriasis will lead to an improvement in atherosclerosis in these patients, they concluded. “In the meantime, we recommend that healthcare providers who are caring for patients with psoriasis be vigilant with respect to traditional risk factor screenings. It would be prudent for dermatologists to be familiar with suggested screening for cardiovascular risk factors and recommendations for aspirin use. If not, it is imperative that they work in collaboration with a primary care provider or another internal medicine specialist, who also needs to be aware of our findings.” SOURCE: Archives of Dermatology
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