In the UK, cardiovascular disease is a huge health problem, accounting for around a quarter of all deaths every year. This refers to a range of conditions that affect the heart and circulatory system, including coronary heart disease, heart failure and stroke.
There are a number of factors that can increase your risk for these. Genetics, illness, diet, whether you smoke and how often you exercise all have an influence, for example.
However, experts have also linked a common skin condition to cardiovascular problems. More specifically, psoriasis has a proven association with heart disease.
Psoriasis is a skin condition that causes flaky patches of skin which form scales. These patches normally appear on your elbows, knees, scalp and lower back, but can appear anywhere.
They can also become itchy and sore. Around the world, psoriasis affects an estimated 125 million people.
Aside from the obvious lesions on the skin, this condition can also affect less visible parts of the body.
Dr Joel Gelfand, a professor of dermatology and epidemiology at the University of Pennsylvania Perelman School of Medicine, revealed its link to an increased risk of cardiovascular events.
Speaking to Medical News Today, he said: “There are many lifestyle, genetic, and immunologic connections between psoriasis and cardiovascular disease.”
He explained that scientists have been aware of this link for many years and it is an important area of research.
“The more extensive psoriasis is on the skin, the greater risk the patient has of heart attack, stroke, and mortality,” said Dr Gelfand.
“Underdiagnosed and undertreated, traditional cardiovascular risk factors in psoriasis patients are also critical to mediating this relationship.”
It is currently thought that the inflammation associated with psoriasis drives the development of cardiovascular disease.
This inflammation helps grow plaques in blood vessels and can lead to atherosclerosis, a factor in the risk of cardiovascular diseases.
Some evidence suggests that the increased cardiovascular risk in people with psoriasis may be due to a condition known as coronary microvascular dysfunction (CMD), but previous studies have been small in scale.
A recent study, which was published in the Journal of Investigative Dermatology, set out to replicate those findings in a larger group.
As part of the research, a team analysed data from 448 people with psoriasis.
This included measuring their coronary artery flow, which in healthy people should be between three and six.
Of the participants, they found that 31 percent had a coronary flow reserve of 2.5 or lower, but no sign of coronary artery disease in a follow-up scan.
This meant, around one in three had CMD. CMD is a type of non-obstructive coronary artery disease that causes the small blood vessels feeding the heart muscle to not work as they should.
Compared with participants without CMD, those with CMD were more likely to:
- Be older
- Have a higher body mass index (BMI)
- Have hypertension
- Have psoriatic arthritis.
They were also more likely to have more severe psoriasis and to have lived with the condition for longer.
So, as disease duration and severity increased, so did the risk of CMD.
The study concluded: “In our study, CMD was associated with the severity and duration of psoriasis.
“This supports the role of systemic inflammation in CMD and suggests that the coronary microcirculation may represent an extracutaneous site involved in the immune-mediated injury of psoriasis.
“We should diagnose and actively search for CMD in patients with severe psoriasis.”