Abstract
Introduction: Psoriasis and Psoriatic Arthritis (PsA) are chronic diseases with a number of complications that, among others, may include alterations in the cardio-vascular system. Methods: The aim of this study was to evaluate the risk of Cardiovascular Diseases (CVD) in patients with psoriasis and psoriatic arthritis between the ages of 30-50. The research covered 95 outpatients and inpatients: 51 with plaque psoriasis (23 women and 28 men) and 44 with psoriasis and psoriatic arthritis (16 women and 28 men). The risk of cardio-vascular incident was evaluated with the use of the Framingham algorithm covering the age, total cholesterol, HDL cholesterol, blood pressure, the habit of smoking and diabetes. The 10-year risk of the occurrence of a cardio-vascular incident was higher in patients with psoriatic arthritis than in patients with plaque psoriasis (9,9% vs6,2%). A high risk of cardio-vascular events was observed in 35% men with psoriatic arthritis in comparison to 11% men with only psoriasis. In patients with plaque psoriasis, the increase in the risk of cardio-vascular incident was connected with the late beginning of psoriasis; whereas in the group of patients with psoriatic arthritis, the risk of cardio-vascular incident was connected with the intensification of psoriatic lesions. Conclusion: The patients with psoriasis, especially men with psoriatic arthritis, certainly require special medical care in terms of cardio-vascular diseases prevention.
Highlights
Psoriasis and Psoriatic Arthritis (PsA) are chronic diseases with a number of complications that, among others, may include alterations in the cardio-vascular system
In patients with plaque psoriasis, the increase in the risk of cardio-vascular incident was connected with the late beginning of psoriasis; whereas in the group of patients with psoriatic arthritis, the risk of cardio-vascular incident was connected with the intensification of psoriatic lesions
Among patients with arthritis with severe psoriasis, lower levels of HDL cholesterol, higher levels of LDL cholesterol and higher values of systolic and diastolic blood pressure were observed in comparison with the group with psoriatic arthritis without severe skin involvement (Table 5)
Summary
Psoriasis and Psoriatic Arthritis (PsA) are chronic diseases with a number of complications that, among others, may include alterations in the cardio-vascular system. Gender, smoking, hypertension, hyperlipidemia or type 2 diabetes are traditional risk factors, and obviously influence the progress of CVD. This occurs in patients with psoriasis and psoriatic arthritis. The patients with a defined high risk (i.e. 10-year risk > 20%) should constitute a group requiring intensive preventive action in the area of modifiable risk factors (hypertension, dyslipidemia, diabetes t.2) The simplicity of this algorithm enables it to be used in everyday practice and the height of the estimated risk may be a starting point in making a decision about the introduction, the type and intensity of the actions within the prevention of CVD. Our research is the first study that is attempting to compare the estimated risk with the Framingham algorithm risk of cardiovascular incidents in patients with psoriasis or psoriatic arthritis
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