Comparing people in their 50s with psoriasis, diabetes or neither disease, researchers found that moderate to severe calcium buildup was about five times as common in people with diabetes or psoriasis as it was in the others.
“We know that psoriasis accelerates vascular disease, but we’re not sure how or why,” says senior author Dr. Nehal N. Mehta of the U.S. National Heart, Lung, and Blood Institute in Bethesda, Md.
The fact that people with psoriasis have calcium buildup similar to those in diabetes may be a piece of the puzzle, Mehta tells Reuters Health. People with type 2 diabetes are regularly screened for heart disease, which may also be advisable for psoriasis patients, he says.
The researchers studied 387 people who were in their early 50s, on average, and were recruited from outpatient clinics between 2013 and 2015. The participants either had moderate to severe psoriasis but no diabetes or other inflammatory health conditions, or they had type 2 diabetes but no psoriasis or other inflammatory conditions or they had neither psoriasis, diabetes nor any other inflammatory conditions.
At least half of each group had no apparent coronary artery calcium build-up, but 19 people with psoriasis had high levels of coronary artery calcium, as did 20 people with diabetes and just four people with neither disease, according to the results published in JAMA Dermatology, Aug. 24.1
People with psoriasis tended to have fewer other heart disease risk factors like obesity, compared to those with diabetes. And when researchers adjusted for those kinds of factors, especially body mass, the link between diabetes and coronary calcium build-up was no longer significant, but the link to psoriasis remained.
“The results are important confirmation of prior work which has suggested that patients with more severe psoriasis have a similar increased risk of major adverse cardiovascular events compared to diabetes,” says Dr. Joel M. Gelfand, director of the Psoriasis and Phototherapy Treatment Center at the University of Pennsylvania Perelman School of Medicine in Philadelphia.
“The precise mechanism explaining the association of psoriasis and cardiovascular diseases is not known but it is thought that chronic inflammation, common to both disorders, is the primary culprit,” Gelfand, who was not involved in the study, tells Reuters Health by email.
In the short term, coronary artery calcium only presents a low risk to the heart, but becomes more dangerous as it builds up over time, he says.
Patients with psoriasis should be screened for cardiovascular risk factors at least once and annually after age 40, Mehta advises. It also makes sense to try to exercise three to four times per week and adhere to a low fat, low salt diet, he says.
- Mansouri B, Kivelevitch D, Natarajan B, et al. Comparison of coronary artery calcium scores between patients with psoriasis and type 2 diabetes. JAMA Dermatol. 2016 Aug 24. doi: 10.1001/jamadermatol.2016.2907. [Epub ahead of print]