Study Links Metabolic Syndrome to Higher Cardiovascular Risk in Patients with Psoriasis

Psoriasis, a chronic inflammatory skin disease, has long been known to increase the risk of cardiovascular disease, which includes heart attack and stroke. Now, researchers have identified a key culprit: the presence of metabolic syndrome (MetSyn), a condition that includes obesity, diabetes, high cholesterol and hypertension, and is highly prevalent among psoriasis patients.

The findings, which could lead to new ways to help prevent cardiovascular disease among people with psoriasis, appeared online in the Journal of the American Association of Dermatology. The study was funded by NHLBI.

“Metabolic syndrome, so common among our psoriasis patients, drives up coronary artery disease in this population by increasing the plaque buildup that clogs the heart’s arteries,” said Dr. Nehal Mehta, preventive cardiologist and head of NHLBI’s Laboratory of Inflammation and Cardiometabolic Diseases. “Our study shows that, of the MetSyn components, hypertension and obesity contribute the most to coronary plaque buildup, and hence can be good targets for intervention.”

Partly because it worsens vascular and systemic inflammation, psoriasis, a common skin disease affecting 2-3 percent of adults, not only increases but speeds up atherosclerosis, the plaque buildup that clogs arteries and can lead to heart attack and stroke. Metabolic syndrome affects about 25 percent of adults and is on the rise, and its prevalence is even greater among patients with psoriasis.

To reach their conclusions, Mehta and his team conducted an observational study of the NIH Psoriasis, Atherosclerosis, and Cardiometabolic Initiative cohort, which included 260 patients with psoriasis, 80 of whom met the criteria for metabolic syndrome. All participants underwent CT scanning to take pictures of their coronary arteries using a technique called cardiac computed tomography angiography (CTA).

The study found that systemic inflammation, insulin resistance and blood cholesterol were significantly higher in the participants who had both psoriasis and metabolic syndrome. And those with MetSyn had higher coronary artery plaque buildup, a high-risk factor for heart attacks that was assessed by CTA.

Obesity is the most salient aspect of MetSyn. The researchers suggest that identifying metabolic syndrome, especially waist circumference, can help assess cardiovascular disease risk in clinical settings for patients with psoriasis.