Psoriasis and Cardiovascular Problems: Facts and Practical Screening

–Psoriasis is NOT an established risk factor for Cardiovascular problems (based on the American College of Cardiology) – It is classified as an emerging risk factor
–Vascular Inflammation is present on major vessels (aorta, femoral artery) and visible on PET-CT (along with joints and skin) – vascular inflammation may actually represent atherosclerosis

Definition of Cardiometabolic disease (replaces the term Metabolic Syndrome). It consists of any 2 in addition to central obesity:
–disease of blood vessels (eg atherosclerosis)
–insulin resistance
–dyslipidemia

Does treatment of Psoriasis improve CV disease ?
-5 observational studies say “yes”
-However randomized trials are ongoing and have yet to provide a clear-cut answer

How and when should Psoriasis patients be screened ?
-All psoriasis patients should be screened at 18 and every 5 years thereafter (however children could also be screened as there are studies showing dyslipemia already at the age of 10)
–Screening needs to be performed. It can be done by any physician (not necessarily by a cardiologist or dermatologist)

How to screen ? Remember the “3 b’s”
–Blood pressure : seated blood pressure
–BMI calculation, so measure Height and Weight
–Blood sample: fasting glucose and cholesterol levels

Bibliography: Mehta NN; What a dermatologist needs to know. U003 – Comorbidities in Psoriasis: What a Dermatologist Needs to Know. AAD 2016 – Washington DC, United States USA