Psoriasis Linked to Increased Atherosclerotic Risk Regardless of Arthritis Status
Patients with psoriasis demonstrate higher atherosclerotic risk compared with control individuals, independent of whether they have concomitant psoriatic arthritis, according to a cross-sectional study evaluating cardiovascular risk factors and carotid intima-media thickness (cIMT). The findings reinforce psoriasis as a systemic inflammatory disease with cardiovascular implications that extend beyond joint involvement.
Investigators analyzed data from 127 participants, including 78 patients with psoriasis and 49 control individuals. Among the psoriasis cohort, 47 patients had psoriatic arthritis and 31 did not. Demographic characteristics, comorbidities, laboratory markers, and treatments were collected from medical records, while lipid profiles, fasting glucose, and ultrasound-based cIMT measurements were obtained to assess subclinical atherosclerosis.
Compared with controls, patients with psoriasis had significantly higher rates of cardiometabolic comorbidities. The odds of diabetes were more than doubled (odds ratio [OR], 2.3), and the odds of hypertension were markedly increased (OR, 6.8). Structural vascular changes were also evident. Median cIMT values were significantly higher in psoriasis patients than in controls (0.68 mm vs 0.57 mm), indicating greater subclinical atherosclerotic burden.
Notably, the presence of psoriatic arthritis did not appear to further increase cardiovascular risk within the psoriasis population. Traditional atherosclerotic risk factors, including lipid levels and fasting glucose, as well as cIMT measurements, were similar between patients with psoriasis alone and those with psoriatic arthritis. All comparisons between these subgroups were nonsignificant.
The authors concluded that “psoriasis patients, regardless of arthritis status, exhibit increased atherosclerotic risk compared to controls.” However, they noted that “in this sample, it was not possible to prove that the presence of arthritis further exacerbates this risk.”
For dermatologists, the key takeaway is that cardiovascular risk assessment should be considered in all patients with psoriasis, not only those with joint disease. Elevated cIMT suggests early vascular involvement, supporting proactive screening and collaboration with primary care or cardiology to address modifiable risk factors. While psoriatic arthritis carries its own systemic burden, these findings highlight that skin disease alone may be sufficient to confer increased atherosclerotic risk, underscoring the importance of comprehensive, multidisciplinary care in psoriasis management.
Reference
Kahlow BS, Beckhauser AP, Skare TL, Nisihara R. Analysis of cardiovascular risk factors in patients with psoriasis: a cross-sectional study. Mediterr J Rheumatol. 2025;36(4):609-615. doi:10.31138/mjr.300125.pac
