AJC: Patients with severe psoriasis need evaluation of heart disease risk

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Patients with severe forms of the skin disease psoriasis should receive evaluation and possible treatment to reduce their risk of coronary artery disease (CAD), according to new recommendations in the Dec. 10 issue of the American Journal of Cardiology.

Psoriasis affects two to three percent of the world population, including 7.5 million Americans.

“This AJC Editors’ Consensus focuses on a large new area of evidence strengthening the connection between inflammatory processes and CAD,” commented cardiologist and lead author of the article, Vincent E. Friedewald, MD, of the University of Notre Dame, and assistant editor of AJC. “It is a particularly interesting and unique document in that it bridges current knowledge from two medical disciplines—dermatology and cardiology—that rarely interrelate.”

“We recommend that patients with moderate to severe psoriasis be educated about the association of psoriasis and cardiovascular disease and that these patients receive appropriate screening and treatment of modifiable cardiovascular risk factors,” said Joel M. Gelfand, MD, a dermatologist at the University of Pennsylvania.

The explanation for the link between psoriasis and CAD risk is not yet clear, according to the authors, but a leading candidate is inflammation. Regardless of the cause, the panel said that current evidence is strong enough to recommend that doctors assess CAD risk in their patients with psoriasis. Key recommendations in the consensus statement include:

  • Informing patients with moderate to severe psoriasis that they are at increased risk of CAD and performing a medical evaluation to assess cardiovascular risk;
  • Prescribing treatment to reduce high cholesterol levels and other risk factors, if present; and
  • Paying close attention to possible interactions or adverse effects of the medications used to treat psoriasis.