Psoriasis and Cardiovascular Disease: What Patients Need to Know

 Psoriasis and Cardiovascular Disease: What Patients Need to Know

Medical Review Status: Evidence‑based medical content reviewed against peer‑reviewed research and established clinical guidelines.

Why Heart Disease Is a Major Concern in Psoriasis

Psoriasis significantly increases the risk of cardiovascular disease, making heart‑related conditions the leading cause of death among people with moderate to severe psoriasis.

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This elevated risk exists even after accounting for traditional factors such as smoking, obesity, and age—pointing to chronic systemic inflammation as the primary driver.

👉 Related pillar article:
Psoriasis and Metabolic Syndrome: How Chronic Inflammation Increases Mortality Risk

How Psoriasis Affects the Heart and Blood Vessels

Psoriasis triggers persistent immune activation that extends far beyond the skin.

Key Cardiovascular Effects

• Chronic endothelial inflammation
• Accelerated atherosclerosis
• Increased arterial stiffness
• Plaque instability

Inflammatory cytokines such as TNF‑α, IL‑17, and IL‑6 damage blood vessels and promote plaque formation, increasing the likelihood of heart attacks and strokes.

👉 Related cluster:
Systemic Inflammation in Psoriasis: Beyond the Skin

Cardiovascular Conditions Linked to Psoriasis

1. Coronary Artery Disease

People with psoriasis develop coronary artery disease earlier and more aggressively than the general population.

• Higher plaque burden
• Increased myocardial infarction risk
• Greater likelihood of silent heart disease

2. Stroke

Chronic inflammation increases clot formation and vascular damage, leading to:

• Higher ischemic stroke risk
• Increased stroke severity
• Worse long‑term outcomes

3. Hypertension

Psoriasis is strongly associated with:

• Treatment‑resistant high blood pressure
• Endothelial dysfunction
• Increased cardiac workload

4. Heart Failure

Long‑standing inflammation contributes to:

• Myocardial remodeling
• Reduced cardiac efficiency
• Increased heart failure risk over time

Does Psoriasis Severity Matter?

Yes — cardiovascular risk increases with psoriasis severity.

• Severe psoriasis: Highest cardiovascular and mortality risk
• Moderate psoriasis: Significantly elevated risk
• Mild psoriasis: Still higher risk than the general population

Importantly, cardiovascular inflammation may progress even when skin symptoms improve.

The Role of Metabolic Syndrome

Metabolic syndrome amplifies cardiovascular risk in psoriasis.

When combined, psoriasis and metabolic syndrome create:

• Severe insulin resistance
• Accelerated vascular damage
• Markedly increased mortality risk

👉 Related cluster:
Metabolic Syndrome Criteria and Health Risks in Psoriasis

Can Treating Psoriasis Reduce Cardiovascular Risk?

Systemic and Biologic Therapies

Evidence suggests that targeted psoriasis treatments may:

• Reduce vascular inflammation
• Improve endothelial function
• Lower inflammatory biomarkers linked to heart disease

Biologic therapies targeting TNF‑α and IL‑17 show particular promise.

Lifestyle and Preventive Care

Cardiovascular risk reduction requires a comprehensive approach:

• Blood pressure control
• Lipid management
• Weight reduction
• Smoking cessation
• Regular physical activity

Psoriasis patients benefit most from integrated dermatology and primary care management.

Screening Recommendations for Psoriasis Patients

Routine cardiovascular screening is essential, especially for patients with moderate to severe disease.

Recommended Monitoring

• Blood pressure
• Lipid profile
• Blood glucose or HbA1c
• BMI and waist circumference
• Family history assessment

Early detection significantly reduces preventable cardiovascular events.

Key Takeaways

• Psoriasis significantly increases cardiovascular disease risk
• Chronic systemic inflammation is the primary driver
• Heart disease is the leading cause of death in psoriasis
• Risk rises with disease severity and metabolic syndrome
• Early screening and treatment improve outcomes

Medical References

1. Mehta NN, et al. Psoriasis and cardiovascular disease. JAMA.
2. Boehncke WH, et al. Psoriasis and atherosclerosis. Lancet.
3. Gelfand JM, et al. Risk of myocardial infarction in psoriasis. JAMA.
4. Takeshita J, et al. Psoriasis comorbidities and cardiovascular risk. J Am Acad Dermatol.