Psoriatic arthritis (PsA) is an inflammatory form of arthritis that can affect the skin and joints. An increasing body of research links the condition to heart disease.

PsA is an autoimmune disease, meaning that it occurs when the immune system mistakenly launches an attack on the body. This attack can trigger inflammation and pain.

There is a known link between PsA and heart health, with research showing that PsA increases the risk of cardiovascular conditions. It is likely that specific symptoms of PsA and the increased likelihood of other risk factors play a role.

In this article, we explain the connection between PsA and heart disease. We also cover what the latest research says and suggest strategies to reduce the risk of cardiovascular disease when living with PsA.

Most of the existing research exploring the link between heart disease and rheumatological diseases has focused on rheumatoid arthritis. Recently, however, there has been a growing body of research that links PsA and cardiovascular disease.

In a 2016 meta-analysis, researchers examined data from 11 studies involving a total of more than 30,000 people with PsA. They found that people with PsA had a 43% higher risk of cardiovascular disease than those without PsA. This finding suggests that PsA is an independent risk factor in the development of cardiovascular disease.

However, research also suggests that specific symptoms of PsA, such as inflammation in the sacroiliac joints in the back, can increase a person’s chance of a cardiovascular event. In a 2014 study, researchers identified an association between inflammation in the sacroiliac joints and increased aortitis. Aortitis is the term for inflammation of the aorta, which is a known predecessor of cardiovascular disease.

PsA and most forms of heart disease are inflammatory conditions. When the immune system launches an inflammatory response, it affects systems all over the body, including the joints, skin, and heart. Chronic inflammation is a known risk factor for heart disease, and it can also cause damage to blood vessels.

In addition to the risk factor of bodywide chronic inflammation, people with PsA are also more likely to have traditional risk factors for heart disease, such as diabetes or obesity.

In a 2019 study, researchers found that those with PsA were more likely to have type 2 diabetes, hypertension, hyperlipidemia (high levels of fat in the blood), and obesity. These are all risk factors for heart disease.

Metabolic syndrome is an umbrella term for a group of conditions that increase the risk of heart disease. In another study, researchers found that 44% of those with PsA had metabolic syndrome. People with severe PsA were more likely to have metabolic syndrome.

People with PsA can take steps to reduce the risk of cardiovascular disease and morbidity.

Understand the risk factors

Individuals with PsA should consider whether they are already at higher risk of cardiovascular disease due to other risk factors, which include:

  • high blood pressure
  • high cholesterol
  • type 2 diabetes
  • history of smoking
  • sedentary lifestyle
  • excess body weight

If a person with PsA has any of these risk factors, they should talk with their doctor about what they can do to improve their heart health.

In 2019, the American College of Cardiology and the American Heart Association (AHA) put out new guidelines for preventing heart disease. In these guidelines, they include psoriasis and other rheumatic inflammatory diseases as risk enhancers for heart disease. They advise that risk-enhancing factors such as PsA should guide preventive interventions for adults who are at risk of heart disease.

Those with PsA may benefit from regular screening for heart disease risk factors, including blood pressure, cholesterol, and excess body weight.

Review medications with a doctor

Some medications for PsA may reduce the risk of heart disease, while others may increase it.

For example, steroids can raise cholesterol levels and cause the body to become less sensitive to insulin. In turn, this can contribute to the risk of cardiovascular disease.

Conversely, biologics and disease-modifying antirheumatic drugs (DMARDs) can not only ease pain in the joints but also protect the heart.

Make lifestyle adjustments

A person can make simple changes to their diet and everyday habits to help reduce PsA symptoms and improve heart health.

Eating a diet that is rich in fruits and vegetables, whole grains, and fish but low in red meat can help minimize inflammation. Fatty fish, such as salmon and mackerel, contain anti-inflammatory fatty acids. Research has indicated that consuming these fish may protect those with PsA from heart disease.

Reducing sugar intake also helps lower inflammation.

In addition, excess weight can increase the risk of both PsA and heart disease. Losing weight can help with symptoms of PsA, such as joint tenderness, and also lower the risk of heart disease.

Medications to control cholesterol, blood pressure, and blood sugar may be useful for some people living with PsA.

For smokers, quitting smoking will lower the risk of heart disease. It will also promote better overall health.

PsA is a chronic condition with known links to cardiovascular disease. Research suggests that PsA is an independent risk factor in developing heart disease. People with PsA are also more likely to have other risk factors for heart disease, such as metabolic syndrome.

However, these individuals can take several steps to reduce the risk of cardiovascular disease and morbidity. These include learning about and being aware of risk factors, undergoing regular screening, and adopting a healthy lifestyle. A doctor can offer advice on whether any medications might also be helpful.

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