Should Psoriasis Patients be Screened for Heart Disease


  • Michelle De Deyn School of Medicine, Trinity College, University of Dublin, Ireland
  • Ciara Guerin School of Medicine, Trinity College, University of Dublin, Ireland
  • Kevin Moloney School of Medicine, Trinity College, University of Dublin, Ireland
  • Yasmine Roden School of Medicine, Trinity College, University of Dublin, Ireland
  • Neelam Nath School of Medicine, Trinity College, University of Dublin, Ireland




Psoriasis is a systemic, immune-mediated disorder that manifests as chronic skin and joint inflammation. While the prevalence of psoriasis worldwide is 2%, its prevalence in developed countries is on average about 4.6%. Psoriasis is associated with cardiovascular disease (CVD). For this literature review, Pubmed and Medline were used to source articles using the keywords ‘psoriasis’ and ‘cardiovascular disease’. The inclusion criteria were studies with sample sizes of 100 or more published in English from 2000 onwards. Out of 1,657 papers retrieved, 37 were deemed relevant. Of these, 36 papers contained evidence in support of screening for CVD while one paper had evidence against screening for CVD. Substantial evidence suggested a higher CVD prevalence in psoriasis patients compared to populations without psoriasis. Furthermore, the risk of develop- ing CVD correlated highly with increased psoriasis severity and duration in addition to other CVD risk factors. The pathophysiological link between psoriasis and CVD is a common immunological pro-inflammatory state. In conclusion, psoriasis is an independent risk factor for CVD, particularly in younger patients with severe psoriasis, and is associated with increased mortality. Further research is required to better understand the relationship between psoriasis, traditional risk factors and development of CVD.


1 Reich, K. Review Article - The concept of psoriasis as a systemic inflammation: implications for disease management. Journal of the European Academy of Dermatology and Venereology 26, 3-11 (2012).
2 Lebwohl, M. Psoriasis. The Lancet 361, 1197-1204 (2003).
3 Feldman, S. & Krueger, G. Psoriasis assessment tools in
clinical trials. Annals of the Rheumatic Disease 64, 65-68 (2005).
4 WHO. Psoriasis. In Executive Board 133rd session (ed. Secretariat, R.b.t.) (2013).
5 Mitchell, R., Kumar, V., Abbas, A., Fausto, N. & Aster, J. Pocket Companion to Robbins and Cotran Pathological Basis of Disease, (Elsevier Saunders, 2012).
6 Lowes, M., et al. Psoriasis Vulgaris Lesions Contain Discrete Populations of Th1 and Th17 T Cells. Journal of Investigative Dermatology 128, 1207-1211 (2008).
7 Nograles, K., et al. IL-22-producing “T22” T cells ac- count for unregulated IL-22 in atopic dermatitis despite reduced IL-17-produceing TH17 T cells. Journal of Allergy and Clinical Im- munology 123, 1244-1252 (2009).
8 Khattri, S., et al. Cyclosporine in patients with atopic dermatitis modulates activated inflammatory pathways and re- verses epidermal pathology. Journal of Allergy and Clinical Im- munology 133, 1626-1634 (2014).
9 Spah, F. Inflammation in atherosclerosis and psoriasis: common pathogenic mechanisms and the potential for an inte- grated treatment approach. British Journal of Dermatology 159, 10-17 (2008).
10 Bitton, A. & Gaziano, T. The Framingham Heart Study’s Impact on Global Risk Assessment. Progress in Cardiovascular Disease 53, 68-78 (2010).
11 Hippisley-Cox, J., et al. Derivation and validation of QRISK, a new cardiovascular disease risk score for the United Kingdom: prospective open cohort study. British Medical Journal 335(2007).
12 Horreau, C., Pouplard, C. & Brenaut, E. Cardiovascular Morbidity And Mortality In Psoriasis and Psoriatic Arthritis: A Systematic Literature Review. Journal of the European Academy of Dermatology and Venereology, 12-29 (2013).
13 Prodanovich, S., et al. Association of Psoriasis With Cor- onary Artery, Cerebrovascular, and Peripheral Vascular Diseases and Mortality. Archives of Dermatology 145, 700-703 (2009).
14 Kimball, A.B. & Wu, Y. 2009. International Journal of Dermatology 48, 1147-1156 (Cardiovascular Disease and Classic Cardiovascular Risk Factors in Patients with Psoriasis).
15 Johnsson, H., Mccliness, I.B. & Sataar, N. Cardiovascular and Metabolic Risks in Psoriasis and Psoriatic Arthritis: Pragmat- ic clinical management based on available evidence. Annals of the Rheumatic Diseases 71, 480-483 (2012).
16 Samarasekera, E.J. & Neilson, J.M. 2013. Journal of Investigative Dermatolo- gy 133, 2340-2346 (Incidence of CVD in in- dividuals with Psoriasis: A Systematic re- view and meta-analysis).
17 Farajzadeh, S., Zandi, S., Pan- ahandeh, L. & Kamyabi, Z. Prevalence of cardiovascular risk factors in psoriasis pa- tients. Journal of Pakistan Association of Dermatologists 22, 86-90 (2012).
18 Dowlatshahi, E.A., et al. Psoria- sis Is Not Associated with Atherosclerosis and Incident Cardiovascular Events: The Rotterdam Study. Journal of Investigative Dermatology 133, 2347-2354 (2013).
19 Gaeta, M., et al. Role of psoriasis as independent predictor of cardiovascu- lar disease: A meta-regression analysis. International Journal of Cardiology 168, 2282-2288 (2013).
20 NICE guideline, Psoriasis: the management of psoriasis. (2012).
21 Balato, A., et al. Pathogenesis of Psoriasis: The Role of Pro-Inflammatory Cytokines Produced by Keratinocytes. (ed. Psoriais) 9-21 (2012).




How to Cite

De Deyn, M., Guerin, C., Moloney, K., Roden, Y., & Nath, N. (2015). Should Psoriasis Patients be Screened for Heart Disease. Trinity Student Medical Journal , 16(1), Page 23–28. Retrieved from

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