With More Severe Psoriasis Comes Greater Heart Risks: When to Act

At the recent American Academy of Dermatology annual meeting, experts emphasized that psoriasis is more than a skin disease — with implications for long-term cardiovascular health.

In this MedPage Today video, Joel Gelfand, MD, of the University of Pennsylvania in Philadelphia, outlines how psoriasis severity can serve as a marker of cardiovascular risk and the practical steps clinicians should take in response.

Following is a transcript of his remarks:

I just want to briefly mention about psoriasis and cardiovascular risk, and what you as clinicians should be doing for your patients with psoriatic disease.

The first thing to know is that the more extensive someone’s psoriasis is, the greater risk they have of having major cardiovascular events, developing diabetes, and even having premature mortality independent of traditional risk factors. And so as a clinician, when you care for a person with psoriasis and you see their disease being increasingly extensive or increasingly severe, that’s a red flag for you to be sure you educate the patient about these relationships. And really instituting age-appropriate cardiovascular risk factor screening is critically important.

In my practice, I routinely check for hemoglobin A1c to look for diabetes, we’ll check that blood pressure to look for hypertension, and we’ll look for lipids to look for hypercholesterolemia.

And the recent guideline from the American College of Cardiology/American Heart Association defines psoriasis not only as a cardiovascular risk enhancer, but also as a factor that promotes hypertriglyceridemia. And they recommend more aggressive and earlier management of traditional cardiovascular risk factors in patients with psoriasis. So often we’ll be recommending our patients go on medications like statins to help lower their risk of cardiovascular disease.