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Tuesday, October 10th 2006

Psoriasis & Heart Attacks

This shouldn’t be too surprising, but in JAMA (free article) this week a new study shows that those suffering from the inflammatory disease psoriasis are at greater risk for myocardial infarction. From New Scientist,

After controlling for other risk factors, such as high blood pressure, people with psoriasis were up to three times as likely to have a heart attack during that five-year period. The highest elevation of relative heart risk was seen in patients under 50.

For example, compared with people who did not have psoriasis, a 30-year old patient taking medication for this disorder had triple the risk while a 60-year-old patient receiving similar treatment had a 36% increased risk of heart attack.

“I was surprised that for younger people with severe psoriasis the increased risk was as great as that associated with diabetes. That put it into perspective,” says Gelfand. He adds that psoriasis in people under 50 years is more likely to have genetic causes and involve severe inflammation.

However, atherosclerosis and in turn CAD, has a major component of inflammation run amok in its pathophysiology. Elevated c-reactive protein, a marker for systemic inflammation, is a risk factor in CAD. And as the JAMA study authors point out,

Psoriasis is also associated with markers of systemic inflammation, such as increased C-reactive protein levels.

Indeed the inflammation in psoriasis is not always simply relegated to the skin. In 20% of patients arthritis develops.

The level of the increased risk however is noticable. Of course we’re playing around with relative risk again,

There were 11 194 MIs (2.0%) within the control population and 2319 (1.8%) and 112 (2.9%) MIs within the mild and severe psoriasis groups, respectively.

2% baby. Oh yeah.