Psoriasis and Vascular Risk : An Update
Niki Katsiki, Panagiotis Anagnostis, Vasilios G. Athyros, Asterios Karagiannis and Dimitri P. Mikhailidis
Affiliation: Dept. of Clinical Biochemistry (Vascular Disease Prevention Clinics), Royal Free Hospital campus, University College London Medical School, University College London (UCL), Pond Street London NW3 2QG, UK.
Keywords: Cardiovascular disease, metabolic syndrome, non-alcoholic fatty liver disease, psoriasis, psoriatic arthritis, vascular risk factors.
Psoriasis is a chronic systemic inflammatory disease characterized by topical skin lesions as well as an increased risk for cardiovascular
disease (CVD). There is also increasing evidence that patients with psoriasis are more prone to several CVD risk factors (hypertension,
obesity, dyslipidemia and smoking), non-cardiac vascular diseases (carotid, peripheral artery and chronic kidney disease) and
metabolic co-morbidities (type 2 diabetes mellitus, metabolic syndrome, non-alcoholic fatty liver disease and obstructive sleep apnea)
compared with the general population. The associations are even greater in patients with severe psoriasis and those with psoriatic arthritis.
Insulin resistance, endothelial dysfunction and obesity induced by several adipokines and inflammatory cytokines are proposed as the
common mechanisms linking psoriasis with CVD, vascular risk factors and metabolic diseases.
The present narrative review considers the associations between psoriasis (and psoriatic arthritis) with CVD, vascular risk factors and
metabolic diseases. Drugs that reduce CVD risk and improve metabolic parameters may also beneficially affect psoriasis severity and
prognosis. Furthermore, anti-psoriatic drugs can exert different effects on CVD risk and metabolic co-morbidities. Therefore, physicians
should be aware of these associations in order to adequately monitor and treat psoriatic patients.
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