How to Manage Cardiovascular Disease in Psoriatic Disease: Evidence and Time Management in Clinic

Early recognition and appropriate management of cardiovascular (CV) disease (CVD) in patients with psoriatic disease (PsD) is critical for prevention of early morbidity and mortality. PsD and CVD share common pathogenic mechanisms, including upregulation of proinflammatory cytokines like tumor necrosis factor. Potential CV comorbidities should be assessed in all patients with PsD through clinical history, risk factor assessment (eg, diabetes, hypertension, dyslipidemia), blood tests, and imaging, when required. Collaboration with the patient's primary care physician is essential, offering preventive measures such as healthy lifestyle advice (eg, diet, exercise, weight loss, smoking and drinking cessation). Management of comorbid conditions requires a multidisciplinary setting of family doctors, internists, cardiologists, dermatologists, and rheumatologists. Treating psoriatic arthritis and psoriasis to remission is recommended; however, the data on CVD risk modification remain inconclusive, necessitating further studies. Thus, routine CVD assessment and management should be provided to patients with PsD, despite practical difficulties such as clinical time constraints and lack of support staff. The evidence and experiences of a dermatologist and rheumatologist assessing and managing CVD in clinic were presented at the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) 2024 annual meeting.