Increased risk of stroke in patients with psoriasis: A systematic review and meta-analysis

Psoriasis is a chronic inflammatory skin disorder affecting 2% to 3% of the global population and is increasingly linked to systemic complications, including cardiovascular events like stroke. This meta-analysis aimed to clarify the relationship between psoriasis and stroke risk.

We systematically searched PubMed, Google Scholar, and Cochrane databases for observational studies published through December 2024 that evaluated stroke risk in psoriasis patients. Studies were selected according to PRISMA guidelines, and data were extracted on patient characteristics, study design, and adjusted risk estimates.

A total of 18 studies involving 705,602 psoriasis patients and 17,971,569 controls were included. Using a random-effects model, the overall pooled hazard ratio (HR) for stroke in psoriasis patients was 1.24 (95% confidence intervals [CI]: 1.15-1.35, P <.05). When stratified by disease severity, mild psoriasis had an HR of 1.09 (95% CI: 1.02-1.16), whereas severe psoriasis showed a higher risk with an HR of 1.36 (95% CI: 1.21-1.53). Regional analyses indicated increased stroke risk in Asia (HR = 1.08), Europe (HR = 1.26), and North America (HR = 1.49). Age subgroup analysis further supported a consistent association across different age groups.

Our meta-analysis indicates that psoriasis is associated with a significantly increased risk of stroke, particularly among patients with severe disease and older age. These findings highlights the importance of comprehensive cardiovascular risk management in individuals with psoriasis. Further research needed to explore the underlying mechanism in this high-risk population.