Doctors have known for some time that people with severe psoriasis — plaques covering more than 10 percent of their bodies — are at greater risk for strokes and heart attacks.
Based on a growing body of research, experts say that severe psoriasis increases the likelihood of having a heart attack or stroke (or dying from these conditions) by an additional 6 percent over 10 years. This increased percentage places patients with severe psoriasis in a higher risk category than previously recognized.
“It was established that severe psoriasis predisposes patients to hardening of the arteries, which can lead to heart attacks and strokes,” says Nehal N. Mehta, MD, MSCE, director of inflammatory risk in Penn’s Preventive Cardiology Program in Philadelphia and the lead author on one study of psoriasis and heart problems.
The 6 percent risk is added to a patient’s other risk factors, Dr. Mehta explains. So you could be in serious danger of having a heart attack or stroke if you have severe psoriasis and one or more of these other risk factors:
- Being overweight
- Having high blood pressure
- Being a smoker
- Having diabetes
- Having high cholesterol
- Having a family history of heart attacks
- Being sedentary and not exercising
Quantifying the additional risk is important, Mehta stresses, because it should encourage doctors and their patients with severe psoriasis to be more aggressive in trying to prevent cardiovascular disease. Patients may need to make more aggressive lifestyle changes and sometimes need to take drugs to help lower their blood pressure and reduce the fat in their blood, he says.
Doctors still are not certain why there is a link between psoriasis and heart disease. They suspect that the cells from the inflammation seen with psoriasis also are involved in the dangerous plaque build-up in blood vessels, Mehta says.
Four Ways to Reduce Your Risk
What can you do if you have severe psoriasis and want to lower your risk of heart disease? Mehta and the American Heart Association recommend that you:
- Quit smoking. If you smoke, you are two to three times more likely to have a fatal stroke or heart attack than someone who does not. Once you stop smoking, you immediately reduce your risk and, within a few years of stopping, your risk for sudden cardiac death may be comparable to nonsmokers.
- Eat a heart-healthy diet. You can lower your risk of cardiovascular disease by eating a diet rich in fruits, vegetables, and whole grains, and low in fat and sugar. Choose lean meats and low-fat dairy as well as whole grains rather than processed foods.
- Get regular exercise. The heart is a muscle. You can improve its ability to function with regular exercise. Aim for at least 30 minutes of aerobic exercise five days a week. Good aerobic exercises include walking, swimming, bicycling, and dancing.
- Get regular check-ups. Monitor your blood pressure, blood cholesterol, and weight. If they’re too high, you and your doctor should talk about the best treatments to lower them, Mehta says. Also, have your blood sugar checked regularly to be sure you don’t have diabetes. Be aware of heart disease symptoms and talk to your doctor if you experience them.
Having severe psoriasis is enough to deal with — you don’t need to worry about whether you will have a heart attack or stroke, too; especially when simple lifestyle changes can control many of your risk factors.