Psoriasis and Heart Disease

Psoriasis defined as a chronic skin disorder that commonly affects 1% to 3% of the worlds population. Psoriasis is characterized by periodic flare-ups of red patched covered by a silvery and flakey scale typically on the scalp. There are several variations of psoriasis, but the most common plaque psoriasis, but the exact cause of psoriasis is unknown. It is believed that a combination of several factors contribute to the development of psoriasis. Psoriasis causes itchy, painful patches of thick, red, scaly skin. The chronic disease is thought to start with the immune system overreacting and targeting the bodys own cells. More than 5 million Americans suffer from psoriasis, but most do not have the most severe form.

In an immune system that functions normally, white blood cells produce antibodies to bacteria and viruses. These white blood cells also produce chemicals which help to aid in healing and fighting infective agents. Psoriasis causes special white blood cells, called T-cells, to become overactive. T-cells attack the skin which sets off a series of events which make the skin cells multiply quickly enough so they start to stack up on the surface of the skin. Normal skin cells are typically sloughed off every thirty days, but in plaque psoriasis the skin goes through the entire process in three to six days.

Recent research has shown that there is a small increased risk of coronary arterial disease in patients with psoriasis, especially in younger people. Psoriasis is an immunological mediated disease and there may be an association with cardiovascular disease. A similar association that exists between psoriasis and cardiovascular disease is also found in cases of rheumatoid arthritis. The conditions involve a similar immunological mediated response. In both rheumatoid arthritis and psoriasis, this association has been known for years.

People with psoriasis are more likely to smoke and to have diabetes, high blood pressure, and high cholesterol. Researchers have found that even when those risk factors are taken into account, psoriasis still increased the risk of heart attack. Studies have also shown that patients with psoriasis often have key components seen in metabolic syndrome, including hypertension, obesity, elevated lipids, and insulin resistance. The inflammatory process in psoriasis is similar to the inflammatory process that occurs in atherosclerosis, a condition commonly referred to as hardening of the arteries.

Studies show that patients with psoriasis, particularly men, use alcohol and smoking as a form of self-medication, to reduce the emotional consequences of psoriasis. An increased mortality of patients with psoriasis has also been linked to heavy drinking and smoking has been cited as a major risk factor in psoriasis, particularly for pustular psoriasis. Severe psoriasis is also known to cause folic acid deficiency. Folic acid deficiency is linked to high levels of homocysteine which is an additional risk factor for heart disease. The fact that psoriasis is linked to high risk for heart disease suggests that psoriasis is a systemic inflammatory disorder. Whether conventional treatments for psoriasis can reduce this increased risk of heart disease is not yet known.

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