KYOTO, JAPAN — Severe chronic plaque psoriasis is associated with increased arterial stiffness independent of conventional cardiovascular risk factors, reported Dr. Giampiero Girolomoni.
This arterial stiffness, a reflection of endothelial dysfunction, is expressed in a greater carotid-femoral pulse wave velocity on ultrasound than is seen in patients with other skin diseases, said Dr. Girolomoni of the University of Verona (Italy), at an international investigative dermatology meeting.
He reported on 39 patients with severe chronic plaque psoriasis and 38 controls matched for age, gender, and cardiovascular risk factors who had other skin diseases. Their mean age was 51 years. All underwent ultrasound assessment of arterial stiffness as measured by carotid-femoral pulse wave velocity.
Carotid-femoral pulse wave velocity was 8.57 meters/sec in the psoriasis patients and 7.45 meters/sec in controls. This difference remained significant after adjustment for hypertension, dyslipidemia, smoking status, obesity, and hyperhomocysteinemia. A higher value indicates greater impairment of endothelial function.
“We found a positive association between pulse wave velocity and years of psoriasis duration, but not with disease severity. This may suggest that the persistence of skin inflammation rather than its severity is a more relevant risk factor for endothelial impairment,” Dr. Girolomoni said at the meeting of the European Society for Dermatological Research, the Japanese Society for Investigative Dermatology, and the Society for Investigative Dermatology.
Psoriasis is marked by increased production of inflammatory cytokines, including tumor necrosis factor-α interferon-γ and interleukins-1β, −6, and −17. It's likely that even minor elevations in these cytokines, if continuous and long-lasting, may be deleterious, Dr. Girolomoni continued.
“This study suggests that carotid-femoral pulse wave velocity measurement could be used for early recognition of endothelial dysfunction and assessment of cardiovascular risk in psoriasis patients, and that only continuous long-term disease control may be helpful in reducing the cardiovascular risk associated with psoriasis,” he said.