The skin condition psoriasis may increase the risk of stroke and atrial fibrillation, a condition in which the heart beats irregularly, a new Danish study says. In some cases, patients with psoriasis had nearly 3 times the risk of experiencing these conditions compared with people without psoriasis. The risk was greater in patients with severe psoriasis. The findings add to a growing body of research linking psoriasis with heart and blood vessel problems, including an increased risk of heart attack and death from cardiovascular disease. "In recent years, psoriasis has certainly taken the step from a disease affecting appearance to a systemic disease and cardiovascular risk factor," said study researcher Dr. Ole Ahlehoff, a cardiologist at Copenhagen University Hospital Gentofte. Patients with psoriasis should be monitored for indicators of cardiovascular disease, including heart arrhythmias, Ahleoffsaid. And these patients may be candidates for interventions that will reduce cardiovascular disease risk, including lifestyle modifications, such as quitting smoking and getting more exercise, and in some cases, medications, Ahlehoff said. Future studies should investigate whether treating psoriasis reduces patients' cardiovascular disease risk, he said. Psoriasis and the heart Psoriasis is common and causes skin redness and irritation, according to the National Institutes of Health. In those with the condition, skin cells rise to the skin's surface too quickly, which doesn't leave enough time for the old skin cells to fall off, leading to build up of dead skin cells. The condition may be triggered by abnormal signals from the body's immune system. Ahlehoff and colleagues counted the cases of atrial fibrillation and ischemic stroke in the entire adult and adolescent population of Denmark — about 4.5 million people — from 1997 to 2006, using a national database. An ischemic stroke occurs when a blood vessel to the brain becomes blocked. The researchers identified about 36,700 patients with mild psoriasis and about 2,800 with serve psoriasis during that time period. Patients younger than 50 with psoriasis had about a 3-fold increased risk of atrial fibrillation, and a 2.8-fold risk of stroke, compared with those who didn't have psoriasis. Older patients and those with mild psoriasis had a smaller, but still significant, increase in their risk of stroke and atrial fibrillation. The results held even after the researchers took into account factors that could affect the findings, including age, gender, medical treatment and procedures, and level of income. Behind the link Psoriasis patients are thought to be at increased risk for cardiovascular disease for two reasons, said Dr. Robert Kirsner, a professor of dermatology at the University of Miami Miller School of Medicine, who was not involved with the new study. One is that, as a group, they tend to have more cardiovascular risk factors, including obesity, smoking and high lipid levels. The other is that an increase in inflammation in the body links the conditions, Kirsner said. Psoriasis is a chronic inflammatory disease, or a condition in which the immune system is in a constant state of alert, Ahlehoff said. This type of inflammation is also thought to play a role in stroke and atrial fibrillation, Ahlehoff said. Kirsner said the study provides additional support for inflammation as being a factor in psoriasis that increases patients' vascular disease risk. The study was published online Aug. 12 in the European Heart Journal. Pass it on: A growing body of research suggests psoriasis is a risk factor for cardiovascular disease.
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