Psoriasis, the chronic inflammatory skin condition, affecting 2 – 3% of adults worldwide may also be a risk factor for heart attack.
Psoriasis is an inflammatory skin condition – a fact we have known for generations. But it is so much more than that. Psoriasis is also a systemic inflammatory condition and autoimmune disease and has similarities to other inflammatory immune disorders.
For unknown reasons the immune system of the psoriasis sufferer does not function properly. However evidence suggests a complex interaction between genes, environment and lifestyle influences being the cause. Approximately 40% of all people with psoriasis have a close relative with the condition, this coupled with obesity, smoking, heavy drinking, stress, strep infection or some medications may cause the immune system to overreact resulting in psoriasis.
Higher incidence of atherosclerosis and heart attack
Studies show that people with psoriasis have a higher incidence of atherosclerosis (hardening of the arteries), peripheral vascular disease, heart attacks and strokes than people with out the condition, regardless of what initially triggers it.
It is important to note that psoriasis does not cause any of these conditions but rather all the conditions share similar features – inflammation and the activity of cytokine proteins (small secreted proteins which mediate and regulate immunity and inflammation).
Study comparing heart attack risks
A recent study led by Dr Joel Gelfand, assistant professor of dermatology of the University Of Pennsylvania School of Medicine in Philadelphia, compared heart attack risks in approximately 131 000 psoriasis sufferers (almost 4000 of those had severe psoriasis) and a control group of over 500 000 matched people who did not have psoriasis.
The important factor here is that the control group was matched for age, gender, elevated cholesterol, diabetes, smoking and other risk factors. This had not been done in previous studies.
“The study showed that psoriasis was associated with an elevated risk of heart attack in all groups, but especially in younger patients with severe disease. “ (www.healthjockey.com)
For example the results found that a 40 year old person with mild psoriasis has a 20% greater risk of having a heart attack than a 40 year old with out psoriasis. This risk will double for a 40 year old with severe psoriasis.
“The absolute risk is still low, even for someone who has severe disease,” Gelfand says. “If you’re in your 40s or 50s, your risk of having a heart attack each year due to psoriasis is about one in 400 to one in 600. Over 10 years, that adds up to about one in 40-60. So it does become a significant risk factor over time.”
“Only in the last 15 years have we come to understand that psoriasis is an autoimmune disease,” Gelfand says. “Only in the past 10 years have we learned that psoriasis is promoted by the same immune pathways that are active in atherosclerosis.”
Learning that psoriasis increases the risk of heart attack and atherosclerosis is important as patients and doctors alike need to discuss these risk factors and take actions to minimise the risks.