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​​What You Should Know About Psoriasis and Heart Health

By Leah Campbell
Reviewed by Allison Truong, M.D.
February 03, 2023

Like most chronic conditions, psoriasis often goes hand in hand with at least one comorbidity. A comorbidity is a disease that a person experiences at the same time as another one, and there are a few different comorbidities associated with psoriasis, including heart disease.

Studies have demonstrated that people with psoriasis have a very significant increase in heart disease risk,” says Arash Bereliani, M.D., a board-certified cardiologist in Beverly Hills, California.

This increased risk is particularly concerning for people who have severe psoriasis. “They are 54% more likely to suffer a stroke, 21% more likely to have a heart attack, and 53% more likely to die over a 10-year period than people without the skin disorder,” Bereliani says. He adds that they’re also more likely to need surgical cardiovascular procedures like angioplasty, which opens clogged arteries.

Psoriasis and Heart Disease Risk

According to Rhonda Klein, M.D., a board-certified dermatologist at Modern Dermatology, in Westport, Connecticut, it’s the inflammatory nature of psoriasis that contributes to the increased risk of cardiovascular disease.

“Psoriasis causes inflammation on your skin and inside your body, and long-term inflammation within the body may affect the heart and blood vessels, putting a person at a heightened risk for developing heart disease,” Klein explains.

But if you have psoriasis, it doesn’t necessarily mean you will get heart disease. There are some things you can do to reduce your risk.

5 Tips for Heart Health When You Have Psoriasis

Bereliani emphasizes that there are plenty of strategies people with psoriasis can use to protect their heart health.

1. Get Cardiovascular Checkups

It’s important if you have psoriasis to see your primary care physician (PCP) for regular checkups, especially if you're 40 or older. If your PCP decides you need further evaluation by a cardiologist, they’ll refer you to the heart specialist to do additional testing.

“They should also identify if they have other risk factors for heart disease, such as high blood pressure, diabetes, smoking, family history of heart disease, and obesity, and take steps to treat those risk factors,” Bereliani says.

To check for these risk factors, doctors usually do blood pressure screenings and blood tests, such as a lipid panel, a hemoglobin A1C test, and a fasting blood glucose test. The values shown in these test results can change over time, so regularly visiting the doctor will help your physician continue to check on how the numbers are trending.

2. Manage Your Psoriasis

See your dermatologist or rheumatologist regularly to treat your psoriatic condition. Treatment aims to reduce overall body inflammation, which may help to keep your heart healthy in the process.

“If you’re dealing with psoriasis without treatment, chances are you may be simultaneously battling depression and overall not taking great care of yourself, which on its own will put you at an increased risk for heart disease,” Klein says.

Even people with mild psoriatic disease have shown complications related to systemic inflammation, such as joint disease, diabetes, heart disease, and depression. Studies suggest that controlling skin inflammation in general decreases the risk of cardiovascular disease. For people with psoriasis, newer studies suggest that being on systemic therapies, such as biologics or phototherapy, have led to a decrease in inflammatory markers related to heart disease.

3. Follow a Healthy Diet

Klein says that people with psoriasis can often reduce their risk of heart disease through lifestyle choices, including making healthy food choices.

If you’re looking for a specific diet to stick to in the treatment of psoriasis and prevention of heart disease, Bereliani recommends following either a Mediterranean diet or a plant-based diet, which excludes animal-sourced foods, like meat and dairy, as well as anything artificial. Dairy is linked to high cholesterol levels, which may contribute to heart disease, Klein says.

“These two diets are highly anti-inflammatory and help with psoriasis, and they can also reduce the risk of cardiovascular disease,” Bereliani says.

4. Quit Bad Habits

It’s important for cardiovascular health not to smoke, since smoking is known to damage the heart and blood vessels, leading to heart disease. Smoking has also been associated with increased severity of psoriasis and lowered rates of treatment adherence, according to a paper published in Psoriasis: Targets and Therapy.

Klein also recommends keeping alcohol consumption to a minimum. Alcohol is a common trigger for psoriasis flares. Plus, studies suggest that heavy drinking (more than one drink per day for women, or more than one or two drinks per day for men) may create a higher risk of stroke and peripheral arterial disease.

5. Exercise Regularly

Low-impact exercise, such as yoga and walking, can help lower your cortisol levels. That’s helpful because heightened cortisol levels have been linked to heightened inflammation levels, which can fuel and exacerbate psoriasis, according to Klein.

Also, exercise is important for helping you maintain a healthy weight, which is important for overall health. Obesity is not only a risk factor for heart disease but also associated with a higher severity of psoriasis.

“If you have a healthy diet, exercise, and are treating your psoriasis, the increased risk [of heart disease] may not be an issue,” Klein says.

How to Manage Psoriasis and Heart Disease

If you’re already receiving treatment for both psoriasis and heart disease, many of the same tips for preventing cardiovascular disease can also help you to stay healthy with it.

Bereliani says that it’s possible to reduce the inflammation that contributes to both psoriasis and heart disease through a Mediterranean or a plant-based diet, regular exercise, weight loss, and if needed, certain medications.

It’s also important to work with your cardiologist and your dermatologist to manage both your conditions, and to put these specialists in touch with each other to ensure that your treatment plans and medications align, Klein says.

With proper treatment and monitoring, you can live a long and healthy life—one where neither psoriasis nor heart disease keeps you from being with the people you love or from doing the things that bring you the most enjoyment.

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