Psoriasis and psoriatic arthritis are not just skin and joint conditions. They are systemic inflammatory diseases that can also affect your heart and blood vessels. Research shows that people living with these conditions face a higher risk of cardiovascular disease, heart attacks, and strokes. The good news is that the right combination of treatment and lifestyle steps can reduce this risk.
What the Research Shows
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A landmark JAMA 2006 study found that young patients with severe psoriasis had an increased risk of heart attack, even after accounting for traditional risk factors.
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The Karim study in 2012 revealed higher rates of endothelial dysfunction, an early marker of atherosclerosis, especially in untreated moderate to severe psoriasis.
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A 2018 meta-analysis in Frontiers in Rheumatology confirmed that psoriasis is linked to higher rates of hypertension, diabetes, obesity, and cardiovascular events.
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In psoriatic arthritis, studies show greater insulin resistance, increased carotid intima-media thickness, and more coronary artery calcification.
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A 2020 review in Current Rheumatology Reports found that psoriatic arthritis patients had twice the risk of cardiovascular death compared to age-matched controls.
Why It Happens
Chronic inflammation drives the connection between psoriatic disease and heart health. Inflammatory cytokines like TNF-alpha, interleukin-6, and interleukin-17 circulate through the bloodstream. These molecules damage blood vessel walls, promote plaque buildup, and increase clot formation—accelerating atherosclerosis.
Treatments That Protect the Heart
Managing inflammation does more than improve skin and joint symptoms—it may protect cardiovascular health too.
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TNF blockers: A 2018 meta-analysis in Scientific Reports showed TNF inhibitors reduce cardiovascular risk in psoriasis and psoriatic arthritis.
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Interleukin-17 and interleukin-23 inhibitors: These newer biologics have shown promise in reducing vascular inflammation. A 2019 study in Circulation demonstrated interleukin-17 blockade lowered vascular inflammation on PET-CT scans.
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Methotrexate: In rheumatoid arthritis, methotrexate reduced cardiovascular mortality by 21%. Limited data suggest similar protection may apply to psoriatic arthritis when disease is well controlled.
What You Can Do
Prevention starts with knowing your numbers: blood pressure, LDL and HDL cholesterol, hemoglobin A1C, and fasting glucose. Tools like the QRISK3 calculator now include inflammatory diseases in their prediction models.
Lifestyle also matters. An anti-inflammatory diet, such as the Mediterranean diet, regular exercise, adequate sleep, and stress management all help lower inflammation and protect heart health.
Finally, don’t ignore mild psoriasis or psoriatic arthritis symptoms. If your disease is systemic, your treatment should be too.
The Bottom Line
Psoriasis and psoriatic arthritis increase your cardiovascular risk, but you can take steps to protect yourself. With the right medical treatment, lifestyle changes, and awareness, you can lower your risk and safeguard your long-term health.
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