- Researchers report that patients with severe psoriasis are at increased risk of heart disease.
- They note that typical scans for heart disease do not show blockages in small blood vessels.
- They say it’s important for people with blood flow disorders to aggressively target heart disease risk factors.
In the most extensive study to date examining the relationship between coronary blood flow, psoriasis, and heart disease, scientists found that more than 30% of psoriasis patients without symptoms of cardiovascular disease have high rates of coronary microvascular dysfunction. reported that the morbidity rate was low.
The results of those surveys were announced today. Journal of Research Dermatology.
The researchers specifically looked at:
They reported that inflammation seemed to reduce blood flow.
In this study, 503 people with psoriasis but no diagnosis of cardiovascular disease underwent Doppler echocardiography to assess coronary microcirculation. More than 30% of participants had undiagnosed coronary microvascular dysfunction.
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Researchers say there is growing evidence that inflammatory diseases such as psoriasis, psoriatic arthritis, rheumatoid arthritis, and inflammatory bowel disease can lead to endothelial microvascular dysfunction and cardiovascular disease even in the absence of clinically evident cardiovascular disease. We note the high prevalence of microvascular dysfunction.
The researchers in this study wanted to further investigate the relationship between psoriasis and coronary microvascular dysfunction.
Based on the study results, they concluded that systemic inflammation is involved in the development of coronary microvascular dysfunction, but is not associated with smoking, hyperlipidemia, and diabetes, which are typical risk factors for heart disease. It was judged.
Researchers said this study shows that inflammation interferes with many body processes.
“In this case, inflammatory molecules in the blood from psoriasis activity interfere with the ability of blood vessels to constrict and dilate,” said Dr. Chen-Han Chen., is an interventional cardiologist and medical director of the structural heart program at MemorialCare Saddleback Medical Center in California, who was not involved in the study.
“This is consistent with other information about autoimmune diseases,” Chen said. Today’s medical news.
“The main takeaway from this study is that severe psoriasis is associated with a higher prevalence of coronary microvascular dysfunction, independent of traditional cardiovascular risk factors.” said Dr. Stefano Piasellico, Associate Professor of Dermatology and Associate Professor of Dermatology at the University of Padua. of the study authors.
“Severity of psoriasis, duration, and presence of psoriatic arthritis were identified as important predictors of decreased coronary flow reserve. This is important when assessing cardiovascular risk in patients with severe psoriasis. , highlighting the importance of considering inflammation and psoriasis-related factors,” Piasellico said. Today’s medical news.
Our blood is filtered through the large blood vessels, the aorta, and into the small blood vessels, the microvasculature. After confirming that large blood vessels were not blocked, the researchers focused on cells in the microvasculature to determine the cause of the reduced blood flow.
“Coronary flow reserve is a measure that integrates both coronary artery disease and coronary microvascular dysfunction,” said dermatologist specializing in psoriasis at The Ohio State University Wexner Medical Center, who was not involved in the study. said Dr. Jessica Kaffenberger.
“If a patient has coronary artery disease with stenosis (i.e. blockage of blood vessels), their blood pressure will be lower. [coronary flow reserve]” she said Today’s medical news. “Similarly, if there is a dysfunction of the coronary microcirculation (vasculopathy), blood volume decreases. [coronary reserve flow]. In this study, all psoriasis patients were found to have impaired coronary microvascular function, as all vascular CT scans were clear. ”
Endothelial cells form thin lines within blood vessels and regulate their relaxation, allowing them to dilate and allow blood to flow.
“Endothelial cells can be damaged by psoriasis. Pro-inflammatory cytokines are released to help control inflammation in the body,” says the Center for Cardiovascular Disease Prevention at NYU Langone Heart. said Dr. Michael Gershick, director of the rheumatology program. .
“But too many cytokines can cause excessive inflammation, which can cause damage and lead to psoriasis,” said Gershick, who was not involved in the study. Today’s medical news.
Experts say there’s no need to rush to see a cardiologist if you have psoriasis or other autoimmune diseases.
Although autoimmune diseases are a risk factor, they do not automatically cause heart disease, the researchers note.
“You need to have regular check-ups with your doctor,” Chen says. “During your physical exam, your blood pressure should be tested. Your doctor can also request blood tests that measure heart health markers, such as cholesterol. This will help determine if you need to see a cardiologist. You can let your doctor know.”
For people with coronary microvascular dysfunction, it is essential to aggressively target all risk factors for heart disease, explained Gershick.
“Even if there is no relationship, [coronary microvascular dysfunction],” he said. “Researchers have found, for example, that smoking does not contribute to the risk. However, it is a risk factor for heart disease and therefore needs to be addressed. aggressively target all risk factors associated with you.”
