Patients who have more severe psoriasis, an inflammatory skin condition, also have higher levels of inflammation in their blood vessels, a factor that increases risk of heart disease, a new research reveals.

The study provides strong evidence that what is seen on the outside in terms of skin disease severity is mirrored on the inside in terms of blood vessel inflammation, says Dr Nehal Mehta, the study’s senior author and an investigator at the National Heart, Lung and Blood Institute.

In their findings published in the journal Arteriosclerosis, Thrombosis and Vascular Biology, the researchers describe psoriasis as a chronic disease that occurs when skin cells grow too quickly, causing thick, white or red patches of skin. While currently there is no cure for psoriasis, there are treatments that can help patients manage the condition. In Australia, the prevalence of psoriasis is estimated to range from 2.3 per cent to 6.6 per cent.

For the study, the researchers analysed 60 patients with psoriasis and 20 people without the condition. All participants are in their 40s and were at low risk for heart disease. To measure blood vessel inflammation, the team used PET/CT scans. Participants were injected with a radioactive sugar to make inflamed blood vessels appear as bright spots on the scan.

Using scorecards to measure the severity of psoriasis among the participants, the researchers found that some had mild psoriasis, with a few patches on less than three percent of their skin. Those who have patches covering more than 10 percent of the skin, on the other hand, were classified as severe cases.

The scans revealed that all participants with psoriasis, no matter how mild or severe, had increased levels of inflammation in their blood vessels, the researchers report. The worst psoriasis case was found to have a 41 percent increase in blood vessel inflammation, compared with participants without psoriasis. The researchers also note that the link between psoriasis and increased blood vessel inflammation did not change significantly after considering other heart disease risk factors such as blood pressure, cholesterol, blood sugar, weight and smoking.

Using blood tests, the researchers also explored the mechanisms that might explain the association between psoriasis and inflamed blood vessels. Levels of immune cells called neutrophils were found to be higher in patients with more severe psoriasis, Mehta says. Neutrophils play a role in psoriasis and blood vessel inflammation, the researchers note in the study.

While the study does not prove that having psoriasis causes inflammation of the blood vessels, Mehta says it brings scientists one step closer to establishing cause and effect. Previous studies have suggested the relationship between psoriasis and a greater risk of heart attack and stroke and heart disease-related death. This new study may be the first to examine if psoriasis severity affects inflammation in the blood vessels, Mehta notes.

He advises people with psoriasis to lower their risk of heart disease by controlling traditional risk factors. Mehta says those with the condition should avoid smoking and try to maintain a healthy lifestyle, including moderate exercise and a balanced diet. They should also have their blood pressure, cholesterol and blood sugar checked, he adds.

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