Impaired aortic elastic properties in normotensive patients with psoriasis

Psoriasis is a chronic inflammatory disease affecting approximately 1.5-3% of the general population. Several studies have demonstrated an association between psoriasis and atherosclerosis. The aim of this study is the investigate relation between aortic wall stiffness and duration and severity of the disease in patients with psoriasis.

The study population included 58 patients with psoriasis (27 men, mean age = 36.3 ± 10.6 years, and mean disease duration = 9.8 ± 6.7 years) and 36 healthy control subjects (17 men, and mean age = 40.0 ± 11.1 years). Aortic stiffness index, aortic strain and distensibility, were calculated from the aortic systolic and diastolic diameters measured by echocardiography and blood pressure obtained by sphygmomanometer. Cardiac functions were determined by using echocardiography, consisting of standard two-dimensional and conventional Doppler.

The conventional echocardiographic parameters were similar between patients and controls. There were significant differences between the control and the patient groups in aortic stiffness index (2.7 ± 1.0 vs 2.0 ± 0.8, p = 0.001), aortic strain (10.3 ± 3.3% vs 14.2 ± 4.5%, p <0.001) and distensibility (4.2 ± 1.7 × 10(-6) cm(2)/dyn vs 5.8 ± 2.0 × 10(-6) cm(2)/dyn, p=0.001). There were significant negative correlations between the disease duration and distensibility (r = -0.54, p < 0.001), aortic strain (r=-0.41, p=0.001), aortic diameter change (r = -0.35, p = 0.007) and positive correlations between the disease duration and aortic stiffness index (r = 0.58, p < 0.001). Also heart rate and high-sensitive C reactive protein were significantly higher in psoriasis patients than in healthy controls (80.0 ± 11.8 beats/min vs 72.4 ± 8.8 beats/min, p = 0.001 and 9.7 ± 21.4 mg/l vs 3.7 ± 2.1 mg/l, p = 0.04, respectively).

Aortic stiffness measurements were found abnormal in patients with psoriasis. We have also demonstrated that there were significant correlations between aortic stiffness parameters and disease duration. This study suggests that aortic stiffness measurement could be used for assessment of cardiovascular risk in psoriasis patients, and that only continuous long-term disease control may be helpful in reducing the cardiovascular risk associated with psoriasis.