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Published on: March 1, 2024
Psoriasis Beyond the Skin: A Disease With Cardiovascular Risk
Maria Cristofori1, José C González-Rodríguez2, Emmanuel E Cortés-Marín2
1General Practice, Universidad de Ciencias Médicas (UCIMED), San José, CRI.
Insights
Psoriasis patients face higher cardiovascular disease risks due to chronic inflammation. Biologic therapies may reduce this vascular risk alongside skin improvements.
Area of Science:
- Dermatology and Immunology
- Cardiology
- Systemic Inflammation
Background:
- Psoriasis is a chronic immune-mediated skin disease with systemic inflammatory implications.
- It is strongly associated with an elevated risk of cardiovascular disease (CVD), a leading cause of mortality in patients.
- Key cytokines like TNFα, IL-17, and IL-23 drive inflammation, contributing to endothelial dysfunction and atherogenesis.
Purpose of the Study:
- To highlight the link between psoriasis and cardiovascular disease.
- To explain the underlying pathophysiology connecting skin inflammation to vascular complications.
- To discuss the potential of biologic therapies in mitigating cardiovascular risk.
Main Methods:
- Review of current understanding of psoriasis pathophysiology.
- Analysis of the relationship between psoriasis-associated cytokines and cardiovascular risk factors.
- Evaluation of evidence for systemic benefits of biologic therapies.
Main Results:
- Psoriasis involves systemic inflammation contributing to endothelial dysfunction, oxidative stress, and atherogenesis.
- Increased prevalence of coronary artery calcification, impaired microvascular function, and early myocardial infarction are observed.
- Traditional cardiovascular risk assessment may underestimate risk in moderate to severe psoriasis.
Conclusions:
- Psoriasis is a multisystem disorder with significant cardiovascular implications.
- Biologic therapies targeting inflammatory pathways may offer systemic vascular benefits beyond dermatologic improvement.
- An integrated approach to risk assessment and long-term management is crucial for patients with psoriasis.
Abstract:
Psoriasis is a chronic immune-mediated skin disease that is increasingly understood as a systemic inflammatory condition with implications that extend far beyond the skin. Among its most serious associations is an elevated risk of cardiovascular disease, which has emerged as a leading cause of morbidity and mortality in affected patients. The persistent immune activation characteristic of psoriasis, driven by cytokines such as tumor necrosis factor α (TNFα), interleukin (IL)-17, and IL-23, contributes to endothelial dysfunction, oxidative stress, and atherogenesis. This shared pathophysiology helps explain the increased prevalence of coronary artery calcification, impaired microvascular function, and early-onset myocardial infarction observed in this population. Traditional risk assessment tools often fail to capture the actual cardiovascular burden in patients with moderate to severe disease. Evidence suggests that biologic therapies targeting key inflammatory pathways not only improve dermatologic outcomes but may also mitigate vascular risk, offering systemic benefits that extend beyond skin clearance. Recognizing psoriasis as a multisystem disorder reinforces the need for a more integrated approach to risk assessment and long-term management.
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