Updates on cardiovascular comorbidities associated with psoriatic diseases: epidemiology and mechanisms

Abstract

Psoriasis and psoriatic arthritis are associated with a significantly increased risk of cardiovascular risk factors and major adverse cardiovascular events (MACE). Active research is ongoing to elucidate this relationship between psoriatic diseases and cardiovascular comorbidities, as well as their shared pathogenic mechanisms. This review focuses on (1) the epidemiologic association between psoriasis and cardiovascular risk factors, (2) the epidemiologic association between psoriasis and MACE, (3) the epidemiologic association between psoriatic arthritis, cardiovascular risk factors, and MACE, and (4) proposed mechanisms for the contribution of psoriatic diseases to cardiovascular diseases. The proposed mechanisms for shared pathogenesis between psoriatic diseases and cardiovascular diseases are inflammation, insulin resistance, dyslipidemia, angiogenesis, oxidative stress, and endothelial dysfunction. There is complex interplay and overlap among these mechanisms and their contributions to shared pathogenesis. Future translational research is necessary to elucidate the link between psoriatic diseases and cardiovascular diseases. Such findings may be applied clinically to improve the lives of psoriasis patients.

Polyarticular evolution and late‐onset psoriasis may be associated with cardiovascular disease in psoriatic arthritis

“…Classic CVRFs were more frequent in our patients with PsA than in those without this condition. These findings are therefore in line with other data from the literature that find a higher prevalence of metabolic syndrome components in patients with psoriatic disease . However, recent studies have found that 30%‐50% of patients with PsA with atherosclerosis do not have these traditional CVD risk factors .…”

“…Cutaneous psoriasis and PsA are the most important poles of what we now know as psoriatic disease, a systemic entity that goes beyond the skin and joints to encompass other aspects, such as osteoporosis, ocular inflammation, intestinal inflammation, liver disease, and, above all, cardiovascular comorbidity …”

Maternal and infant pregnancy outcomes in women with psoriatic arthritis: a Swedish nationwide cohort study

“…Apart from PsA, spondyloarthritis includes ankylosing spondylitis (AS), inflammatory bowel disease (IBD)‐related arthritis and undifferentiated spondyloarthritis. PsA, as well as skin psoriasis, is associated with co‐morbidities including cardiovascular disease, obesity and metabolic syndrome …”

“…PsA, as well as skin psoriasis, is associated with co-morbidities including cardiovascular disease, obesity and metabolic syndrome. [10][11][12][13] From an overall perspective of chronic inflammatory arthritis and pregnancy outcomes, studies on RA in general report increased risks of preterm birth, [14][15][16][17][18][19][20] infants born small-for-gestational-age (SGA), pre-eclampsia 14,20,21 and caesarean delivery. 14,15,18,21,22 Studies on AS and pregnancy outcomes are scarcer, but a recent Swedish case-control study found increased risks of preterm birth and caesarean delivery.…”

Procollagen‐3 N ‐terminal peptide measurements for the detection of liver fibrosis in methotrexate‐treated patients with psoriasis: daily practice use and clinical implications

“…diabetes or alcohol). 8,9 In our cohort, obesity was correlated with elevated serial PIIINP concentrations. Therefore, developing liver fibrosis in patients with severe psoriasis may also occur via the development of hepatic steatosis, caused by metabolic syndrome combined with severe psoriasis.…”