On the surface, the skin disease known as psoriasis seems to have nothing in common with heart disease, yet research from around the globe suggests the two conditions are linked (1). Research shows that risk factors for heart disease are more frequently found in people with psoriasis than in people who do not have psoriasis (2). Scientists have observed a definite association between psoriasis and a cluster of conditions that increase the risk of heart disease, stroke, and diabetes, known as the metabolic syndrome.
Psoriasis and Heart Disease
These conditions include increased visceral fat (especially fat deposits around the liver and the heart), raised blood pressure, and type 2 diabetes mellitus. Compared to people without psoriasis, the prevalence of hypertension and metabolic syndrome has nearly doubled in those with the disease, with the prevalence of type 2 diabetes increasing more than five times and, in Indian females with psoriasis, the risk of obesity is increased approximately 100-fold.
“It is unclear why this is the case, but it may explain why some people with psoriasis develop heart disease,” says specialist dermatologist Dr. Lushen Pillay. “The inflammation caused by psoriasis appears to increase the risk of developing cardiovascular disease, which is why it’s important to manage the condition. The good news is that you can take action. By making positive changes to your lifestyle and diet you can reduce many of these risk factors and improve the health of your heart. This is especially important as we head into the festive season, a time when many of us may over-indulge.”
What you can change
Since skin and heart health go together, why not focus on both this holiday season? You can reduce your risk of psoriasis flare-ups and heart disease by doing something about the following issues:
High blood pressure
Studies have found that high blood pressure is more common in patients with severe psoriasis. When you have psoriasis, the inflammation can cause many of the conditions, such as high blood pressure, that can potentially lead to heart attacks. Extremely high blood pressure can result in blood vessels in the brain bursting, causing a stroke. Hypertension often has no symptoms, so be sure to have your blood pressure checked every year.
Cholesterol and triglycerides are types of fat that are vital to healthy cell function, but they can also block and narrow the blood vessels, leading to a heart attack or stroke. High cholesterol is associated with high-fat diets, smoking, inactivity, and a family history of high cholesterol. Eating a balanced diet, being physically active, not smoking, and reducing salt and alcohol consumption can significantly reduce your cholesterol levels. Some people may also require medication to control their blood cholesterol. Target healthy cholesterol levels are the same for people with and without psoriasis.
Being inactive can double your risk of heart attack and stroke. You don’t have to exercise strenuously to enjoy the health benefits. Start with a goal of 10 minutes of daily activity, such as walking or gardening. Gradually increase the amount and intensity.
It is essential to manage your blood sugar level if you have diabetes, as more than 80% of people with diabetes die of heart disease.
Your weight can put you at risk of developing heart disease, as well as developing high blood pressure, high cholesterol, and diabetes. Many psoriasis patients are also overweight or obese, a key symptom of metabolic syndrome. There is also evidence that nutrition has an important role in psoriasis and the treatment of it. People who carry weight around their middle (apple-shaped) versus around their hips (pear-shaped) are at greater risk of heart problems. A small reduction in weight – as little as 10% – can significantly reduce your chances of having a heart attack or stroke or developing diabetes, as well as improving your overall wellbeing.
Smoking is one of the most important environmental risk factors in the management of psoriasis. Stopping smoking is also one of the most important steps to take for a healthy heart. Health risks associated with smoking include:
- an increased risk of blood clots
- reduced oxygen in the blood
- increased blood pressure and cholesterol
- heart disease
Stress is another of the most important environmental risk factors in the management of psoriasis. It can also increase your risk of heart disease, and it may encourage your psoriasis to flare. It is important to reduce your stress in a healthy way rather than resorting to unhealthy strategies such as smoking, drinking, and overeating. Exercise, yoga, and relaxation techniques can be effective. Healthy stress release, such as listening to music, meeting with friends, or taking up a hobby is also helpful.
“If you suffer from psoriasis and you have any of the risk factors for heart disease, it is important to try to reduce those risks while also managing psoriasis flare-ups,” says Dr. Pillay. “Talk to your doctor or healthcare advisor. They will be able to provide you with reassurance and explanations of your individual risk factors. Advancements in treatment for psoriasis have also led to the development of a new, dual-combination, topical treatment for mild-to-moderate full body psoriasis, which can help get your psoriasis under control so you too can enjoy this holiday season to the fullest,” says Dr. Pillay.
- Harvard Health Publishing. [11 Nov 2020]. Available from:https://www.health.harvard.edu/heart-health/psoriasis-again-linked-to-heart-disease.
- DeNovo Medica. Issues and Answers. Topical therapy for psoriasis. 2019;Apr:1-2.
- The Psoriasis and Psoriatic Arthritis Alliance. [11 Nov 2020]. Available from:www.papaa.org/learn-about-psoriasis-and-psoriatic-arthritis/further-resources/psoriasis-and-the-heart/.
- The Psoriasis-Hypertension Link — And What You Can Do About It. Everyday Health. [11 Nov 2020]. Available from:www.everydayhealth.com/psoriasis/living-with/psoriasis-hypertension-link-what-you-can-about-it/#:~:text=In%20fact%2C%20more%20than%20half,have%20uncontrolled%20high%20blood%20pressure.