Like many autoimmune diseases, psoriasis puts your body’s immune system into overdrive. This ramps up inflammation. And although psoriasis symptoms are most visible on your skin, inflammation affects other parts of the body, too, including your heart.
When you have moderate to severe psoriasis, you may be up to 50% more likely to get heart disease than someone who doesn’t have the condition. The more severe your symptoms, the higher your chances. Here’s what you need to know.
What Is Heart Disease?
It’s an umbrella term for several conditions that affect your heart. They include:
- Blood vessel disease
- Arrhythmias, or problems with your heart’s rhythm
- Heart valve disease
- Disease of the heart muscle
- Atherosclerosis, the buildup of fat and cholesterol in your arteries
- Heart infection
What’s the Connection Between Psoriasis and Heart Disease?
Researchers are still studying exactly how psoriasis and heart health are linked. They’re trying to figure out whether psoriasis itself ups your risk of heart disease. Or if it’s simply linked to many of the risk factors doctors already know make heart disease more likely, such as:
- Hypertension, or high blood pressure
- Diabetes
- Dyslipidemia, or high cholesterol
- Obesity
Metabolic syndrome, a group of conditions that happen together, is also a risk factor. It includes:
- High blood pressure
- High blood sugar
- Extra body fat around the waist
- High cholesterol levels
Experts think it may be a little bit of both. Research shows that people with psoriasis have more heart disease risk factors than people who don’t. But they don’t understand why.
Possible Links
Experts have looked at several factors to see if they can find a relationship between cardiovascular disease and psoriasis, such as:
Shared genes. The idea is that certain genes that raise your risk of cardiovascular disease may share certain factors with genes that raise your risk for psoriasis.
Common inflammatory pathways. Inflammatory pathways are the flow of signals through cells and blood vessels that lead to inflammation in your body. These pathways may be the same for both heart disease and psoriasis symptoms.
Pro-inflammatory cell signaling molecules. Psoriasis may trigger inflammation in body fat (adipose tissue). This can release certain cell signaling molecules called adipokines that turn on more inflammation and can lead to metabolic syndrome and cardiovascular problems.
Insulin resistance. Insulin is a hormone that helps control the amount of sugar in your blood. When you have psoriasis, your body doesn’t respond as well as it should to insulin. So sugar can build up and lead to type 2 diabetes, which ups your risk of cardiovascular problems.
Lipoprotein. This protein carries cholesterol in the blood. When you have psoriasis, these proteins may have an abnormal makeup that can lead to problems with cholesterol buildup.
New blood vessel growth. Psoriasis patches and plaques tend to trigger the growth of new blood vessels, a process called angiogenesis. This releases growth factors that may lead to atherosclerosis.
Free radicals. The signaling pathways of these unstable atoms that can damage cells may link psoriasis and heart disease.
Microparticles. These are tiny pieces your cells shed. They’re linked to atherosclerosis. People with psoriasis tend to have more of these microparticles than people without the condition.
Hypercoagulability. Psoriasis can increase clotting activity in your blood, making you more likely to have a blood clot.
Although they don’t have clear answers about any of these factors, what they do know is that on average, people with psoriasis have a shorter life expectancy by 5 years. This is mainly due to problems with the heart.
How to Lower Your Risk
No matter what the exact link is, doctors agree that taking good care of your overall health is key to both reducing heart disease risk and improving your psoriasis. You can try the following:
Focus on physical activity. You double your risk of heart attack and stroke when you don’t exercise regularly.
Fine-tune your diet. Carrying extra weight and high blood sugar are risk factors.
Stop smoking. Smoking can worsen psoriasis symptoms. It also makes you much more likely to be diagnosed with atherosclerosis, blood clots, high blood pressure and cholesterol, and heart disease.
Stick to your treatment plan. Some studies suggest that people who treat moderate or severe psoriasis have fewer heart attacks, strokes, and heart-related deaths.
Some psoriasis medications may have heart-health benefits. Typically these are medications doctors prescribe for moderate-to-severe psoriasis.
These medications include:
- Biologics
- Methotrexate
- Ustekinumab (another type of biologic)
These medications can come with side effects. Even if you have an increased risk of heart or blood vessel disease, they may not be right for you. Your doctor can help you decide the best way to treat your psoriasis and lower your chances of harming your heart.