ROCHESTER, Minn. -- People with the skin disorder psoriasis are at increased risk for developing heart disease, according to Mayo Clinic researchers presenting new study data at the American College of Rheumatology Annual Meeting on Nov. 14. Although psoriasis is traditionally viewed as a skin disorder, recent research has led experts to categorize this disease as a systemic inflammatory or immune-mediated disorder. In these disorders, the immune cells attack healthy tissues and organs.
Earlier research has shown that people with autoimmune diseases, such as rheumatoid arthritis and lupus, are at increased risk for heart disease. To study whether a similar risk exists for people with psoriasis, Mayo researchers followed a group of 622 adults with psoriasis and a control group of 622 people, matched for age and gender, who did not have the disease. Researchers examined medical records for subjects in both groups, starting from age 18 until death, and noted the occurrence of heart attack (myocardial infarction) and heart failure in both groups.
Significant Findings Mayo researchers found that the people diagnosed with psoriasis experienced heart attacks more than twice as often as people of the same gender and age in the control group. Those with psoriasis also appeared about 1.42 times more likely to develop heart failure; subjects with psoriasis also appeared about 1.42 times more likely to develop heart failure, but these results were not statistically significant.
"The fact that people with psoriasis exhibit this increased risk for heart disease offers additional proof that psoriasis is a systemic inflammatory disease rather than just a skin disorder," says Sherine Gabriel, M.D., Mayo Clinic epidemiologist and the study's lead researcher.
Mayo researchers hope that these preliminary results may yield additional clues about the mechanisms that contribute to cardiovascular disease.
"We're now seeing increased risk for heart disease associated with a broad range of systemic diseases, all of which share a high level of inflammation and immune system dysfunction," says Dr. Gabriel. "This knowledge could provide us with a better understanding of the connections between these conditions and their underlying causes."
The Mayo research findings also emphasize the need for psoriasis patients to monitor their cardiovascular health at an earlier age and to take measures to lessen their risks for heart attack, heart failure and other cardiovascular problems.
Future research will focus on explaining the potential drivers of this risk by studying the role of cardiovascular risk factors (such as smoking), medications, and biological factors (such as genetics). Facts about psoriasis
Psoriasis is marked by patches of thick, red skin covered with silvery scales that occur primarily on the elbows, knees, legs, lower back and scalp. Although not life threatening, the disease can be painful, affect a person's ability to function, and cause psychological and emotional distress. Facts about heart attack and heart failure
Heart attack is an injury to the heart muscle caused by a loss of blood supply. It usually occurs when a blood clot blocks the flow of blood through a coronary artery -- a blood vessel that feeds blood to a part of the heart muscle. Heart failure, also known as congestive heart failure, usually occurs when coronary artery disease or high blood pressure cause the heart muscle to become too weak or too stiff to pump efficiently.
Collaboration and support
The Mayo Clinic research team also included Hilal Maradit Kremers, M.D., Marian McEvoy, M.D., and Cynthia Crowson. This work was supported in part by grants from Amgen Inc. and the National Institute of Arthritis and Musculoskeletal and Skin Diseases.
Last reviewed: By John M. Grohol, Psy.D. on 21 Feb 2009
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