• Researchers looked over data from thousands of people who underwent testing for suspected coronary artery disease to understand the risk of cardiovascular events in people with psoriasis and psoriatic arthritis.
• The study showed that people with psoriasis and psoriatic arthritis had more plaque buildup in their arteries and had a higher risk of heart disease.

A new study helps people with psoriasis and psoriatic arthritis better understand their risk for developing heart problems. The study, called “Prevalence and Severity of Coronary Artery Disease Linked to Prognosis in Psoriasis and Psoriatic Arthritis Patients: A Multi-centre Cohort Study,” was published on May 12 in the Journal of Internal Medicine.

The researchers undertook the study because they wanted to determine whether people with psoriasis were likely to have more severe coronary artery disease. Coronary artery disease is the most common form of heart disease. It develops when the arteries fill with plaque — material made up of fatty substances, cholesterol, calcium, and other substances. When too much plaque builds up, blood has a hard time flowing through the arteries, leading to heart problems.

Coronary artery disease can be diagnosed with several different tests, including a coronary computed tomography angiography (CTA). This test scores the amount of plaque in the arteries. The higher the coronary artery calcium score (CACS), the higher a person’s risk of heart disease or a heart attack.

In this study, the authors collected information from 46,022 people who had undergone a CTA in Denmark. Of these people, 1,356 had psoriasis and 370 had been diagnosed with psoriatic arthritis (PsA).

The authors found that people with psoriasis and PsA had higher rates of calcium buildup:

• People with psoriasis were 26 percent more likely to have a CACS score above zero, meaning that they had some amount of plaque in their arteries. They were also 25 percent more likely to have very high levels of plaque, compared to people without psoriasis.
• People with psoriasis were 14 percent more likely to have coronary artery disease.
• People with PsA were 28 percent more likely than people without PsA to have plaque buildup.

This study also found that overall, people with psoriasis were more likely to have cardiac events, such as heart attacks, or to die from heart-related conditions. However, the authors concluded that the reason for this trend was that people with psoriasis were more likely to have risk factors, such as high blood pressure, that increased their chances of heart problems.

The authors noted, “In this symptom-driven cohort, it is possible that preventive treatment (preferably with statins and aspirin according to international recommendations), lifestyle changes, and management of cardiovascular risk factors after CTA findings seem to level out the long-term risk of cardiovascular events and all-cause mortality when comparing psoriasis and PsA patients with the reference group.”

In other words, people with psoriasis can make lifestyle changes to help reduce their risk of heart-related disease and death. Ways to improve heart health include:

• Eat less saturated fat, salt, and sugar, and more fruits, vegetables, and whole grains.
• Be more active throughout the day.
• Get seven to nine hours of sleep each night.
• Drink less alcohol.
• Quit smoking.
• If lifestyle habits are ineffective, use medication to lower blood pressure and cholesterol levels.