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 Comparing people in their 50s with psoriasis, diabetes or neither
disease, researchers found that moderate to severe calcium buildup,
or atherosclerosis, was about five times as common in people with
diabetes or psoriasis as it was in the others.
“We know that psoriasis accelerates vascular disease, but we’re not
sure how or why,” said senior author Dr. Nehal N. Mehta of the U.S.
National Heart, Lung, and Blood Institute in Bethesda, Maryland.
The fact that people with psoriasis have calcium buildups similar to
those in diabetes may be a piece of the puzzle, Mehta told Reuters
Health. People with type 2 diabetes are regularly screened for heart
disease, which may also be advisable for psoriasis patients, he
said.
Psoriasis, characterized by itchy red and silvery patches on the
skin, is an autoimmune disease that affects about 2 percent of North
Americans and Europeans. Diabetes is much more common, affecting
about 9 percent of the U.S. population, according to the Centers for
Disease Control and Prevention (CDC).
People with diabetes are twice as likely to have heart disease or a
stroke as people without diabetes, and to experience these at an
earlier age, according to CDC.
One risk factor common to both psoriasis and diabetes and thought to
play a role in elevated heart disease risk is chronic inflammation,
which is known to promote arterial buildup.
The researchers studied 387 people who were in their early 50s, on
average, and were recruited from outpatient clinics between 2013 and
2015. The participants either had moderate to severe psoriasis but
no diabetes or other inflammatory health conditions, or they had
type 2 diabetes but no psoriasis or other inflammatory conditions or
they had neither psoriasis, diabetes nor any other inflammatory
conditions.
At least half of each group had no apparent coronary artery calcium
build-up, but 19 people with psoriasis had high levels of build-up,
as did 20 people with diabetes and just four people with neither
disease, according to the results in JAMA Dermatology.
People with psoriasis tended to have fewer other heart disease risk
factors like obesity, compared to those with diabetes. And when
researchers adjusted for those kinds of factors, especially body
mass, the link between diabetes and coronary calcium build-up was no
longer significant, but the link to psoriasis remained.
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“The results are important confirmation of prior work which has
suggested that patients with more severe psoriasis have a similar
increased risk of major adverse cardiovascular events compared to
diabetes,” said Dr. Joel M. Gelfand, director of the Psoriasis and
Phototherapy Treatment Center at the University of Pennsylvania
Perelman School of Medicine in Philadelphia.
“The precise mechanism explaining the association of psoriasis and
cardiovascular diseases is not known but it is thought that chronic
inflammation, common to both disorders, is the primary culprit,”
Gelfand, who was not involved in the study, told Reuters Health by
email.
In the short term, coronary artery calcium only presents a low risk
to the heart, but becomes more dangerous as it builds up over time,
he said.
“Get screened for cardiovascular risk factors at least once if you
have psoriasis, and after the age of 40 they should get screened
annually,” including measures of blood pressure, body mass index and
cholesterol levels, Mehta said.
It also makes sense to try to exercise three to four times per week
and adhere to a low fat, low salt diet, he said.
SOURCE: http://bit.ly/2ccp8n1 JAMA Dermatology, online August 24,
2016.
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