Can Psoriasis Affect the Heart?

Author: Dr Azuka Chinweokwu Ezeike, MBBS, FWACS, FMCOG, MSc (PH)

Highlights

• Psoriasis is an autoimmune disease characterised by chronic inflammation
  
  
• Inflammation in psoriasis can affect the skin as well as the heart and blood vessels
  
  
• Severe psoriasis increases the risk of heart attack and stroke
  
  
• Screening for heart disease is important in patients with psoriasis
  
  
• Medications such as methotrexate and TNF inhibitors may reduce heart risk
  
  
• Lifestyle changes can lower the risk of heart disease in psoriasis patients

Introduction

You have a skin disease that you have managed over the years. The major problem is that it causes cosmetic problems, leading to poor body image. Sometimes, the itching becomes quite uncomfortable. Then, suddenly, you experience chest pain, visit the hospital for checks, and are surprised to be diagnosed with a heart problem. 

The most intriguing part is discovering that heart disease is related to the seemingly non-life-threatening skin condition. Your problem is no longer just the skin disease; you are now worried about dying early.

This article explains how psoriasis, a skin condition, can be linked to problems in other parts of the body, especially diseases of the heart and blood vessels.

What is Psoriasis?

Psoriasis is a long-term skin condition that results from the rapid growth of skin cells [1]. It is an autoimmune disease, a condition in which the body’s immune system attacks its own cells. The hallmark of psoriasis is sustained inflammation that leads to uncontrolled keratinocyte (skin cells) growth.

The disease is linked to genes and is more common among close relatives. It affects all races but is more common in whites than in blacks. It can occur at any age, but up to 75% of people with the disease develop it before 40 years.It appears as red patches of skin covered with silvery-white scales [1].

These patches are most often seen on the:

• Elbows
  
  
• Knees
  
  
• Scalp
  
  
• Lower back
  
  

The disease usually comes and goes and has no permanent cure. However, temporary relief can be obtained with some medications. There are different types of psoriasis, but plaque psoriasis is the most common.

What Diseases Are Associated with Psoriasis?

Psoriasis is associated with inflammation, and this does not occur only in the skin. Other parts of the body are also affected [1, 2].

These include the:

• Eyes
  
  
• Joints
  
  
• Blood vessels
  
  
• Heart
  
  

Because of this, psoriasis is associated with diseases such as: 

• Eye disease, including uveitis, cataract,  conjunctivitis, and corneal dryness [3].  Blepharitis (swelling of the eyelids) is the most common eye disease linked with psoriasis.
  
  
• Joints: Psoriasis is associated with swelling and pain in the joints, especially the knees and hips. This is known as psoriatic arthritis.
  
  
• Nails: Onycholysis, leukonychia (white nails), and other nail changes.
  
  
• Metabolic syndrome, which includes:
  
  
  • Dyslipidaemia (High blood cholesterol level)
    
    
  • Hypertension
    
    
  • Coronary artery disease (Heart blood vessel disease)
    
    
  • Type 2 Diabetes
    
    
  • Obesity
    
    

Other associated diseases include:

•  Inflammatory bowel disease
•  Liver disease
•  Chronic kidney disease.

What is Heart Disease?

Heart disease refers to any condition that affects the heart muscle, the pattern of heartbeat, or the blood vessels in the heart.

How Does Psoriasis Affect the Heart and Blood Vessels?

Most heart problems are due to the buildup of deposits in the blood vessels (atherosclerosis). This buildup is linked to the function of special white blood cells called T helper cells.

In psoriasis, there is widespread inflammation, also associated with the activation of the T helper cells.This means the same immune system and inflammatory problems contribute to both atherosclerosis and psoriasis [2]. 

 When T-cells are activated, they trigger the activation of other white blood cells, such as macrophages and neutrophils. These form deposits (plaques) on the walls of blood vessels, narrowing them.

At the same time, higher levels of inflammatory chemicals called cytokines damage the endothelium (the lining of blood vessels).

Psoriasis-related heart disease is common in younger people with severe disease. Evidence shows that within 10 years of diagnosis, patients with severe psoriasis have a high risk of harmful cardiac events, such as stroke and myocardial infarction [4].

According to the National Psoriasis Foundation, the relationship between these two diseases has been studied for about two decades by a research team led by Joel Gelfand, professor of dermatology and epidemiology at the Perelman School of Medicine.

Other explanations for the link include:

• Metabolic syndrome is twice as common in people with psoriasis compared to those without it.
  
  
• Psoriatic arthritis, which leads to a higher risk of immobility, further increases the risk of heart disease [4].
  
  
• Psychiatric conditions such as depression, which are more common in psoriasis and linked to increased risk of ischaemic heart disease and stroke [5].
  

What Types of Heart and Blood Vessel Disease are Associated with Psoriasis?

Some of the heart diseases associated with Psoriasis include: [2,4] 

• Myocardial infarction (Heart attack due to loss of blood flow)
  
  
• Stroke (Brain attack due to loss of blood flow)
  
  
• Non-ischaemic dilated cardiomyopathy (weakened, enlarged heart)
  
  
• Atrial fibrillation (irregular heartbeat)
  
  
• Coronary artery disease (narrowing or blockage of the heart's blood vessels)
  
  
• Heart failure (when the heart cannot pump blood well enough)
  
  How Can Psoriasis-Related Heart Disease Be Treated?
  Managing psoriasis and reducing heart risk often go together. Treatment involves using systemic (whole body) medications for psoriasis and drugs for the specific heart disease. The choice of treatment by your doctor depends on disease severity and other associated conditions.Common medications for psoriasis include:
  • Methotrexate
    
    
  • Cyclosporin
    
    
  • Acitretin (a retinoid)
    
    
  • Biologic therapies such as Tumour Necrosis Factor Inhibitors (TNFi) and Ustekinumab
    
    
• Methotrexate and TNFi have been shown to reduce heart disease risk. The effects of other medications on the heart are still being studied.Medications for heart conditions may include:
  • Statins, especially in patients with high cholesterol
    
    
  • Antihypertensive drugs (e.g., labetalol, methyldopa)
    
    
  • Diabetes medications such as insulin and metformin
    
    

Screening for Heart Disease in Patients with Psoriasis

Your dermatologist (skin doctor) or rheumatologist will not only treat your skin disease but will also check your risk of heart disease. This is especially important if you have severe psoriasis (a disease affecting more than 10% of skin surface or requiring systemic drugs such as methotrexate).

Yearly checks according to guidelines include:

• Blood pressure
  
  
• Blood sugar
  
  
• Haemoglobin A1c
  
  
• Fasting lipid profile
  
  
• Body mass index
  
  
• Electrocardiogram (ECG) is required if you have an abnormal heart rate
  
  
• 10-year cardiovascular risk score (calculated by your doctor)
  
  

Other tests may be required based on your doctor’s assessment.

How to Reduce Your Risk of Heart Disease if You Have Psoriasis

The risk of cardiovascular disease can be reduced with lifestyle-modifying behaviours. 

• Exercise regularly
  
  
• Follow a low-calorie diet plan
  
  
• Manage stress
  
  
• Maintain a healthy body weight
  
  
• Stop smoking
  
  
• Use psoriasis medications as recommended by your doctor
  
  
• Control blood pressure, blood sugar, and cholesterol

Your doctor may also prescribe medications to reduce your risk: [6]

• Statins to lower the risk of myocardial infarction
  
  
• Metformin to slow the progression of metabolic syndrome and support weight loss
  

When to Seek Urgent Help

If you have psoriasis and develop chest pain, sudden shortness of breath, weakness on one side of the body, or difficulty speaking, it may be a sign of a heart attack or stroke.  Call emergency services or go to the nearest hospital immediately.

Conclusion

Psoriasis is more than a skin disease. Because of long-term inflammation, it can increase your risk of heart problems and other conditions. The good news is that with proper screening, healthy lifestyle habits, and the right treatment, you can greatly reduce this risk. Work with your doctor to manage both your skin and your heart, and do not ignore new or sudden symptoms. With proper care, the risk of severe heart disease can be significantly reduced.

Frequently Asked Questions (FAQs)

1. Does Treating Psoriasis Improve Heart Health?

Some psoriasis treatments, such as methotrexate and TNFi, have been shown to reduce inflammation and may lower the risk of heart disease. Other medications are still being studied for their effects on the heart.

2. Can Mild Psoriasis Also Increase Heart Disease Risk?

Even people with mild psoriasis may have a slightly higher risk of heart problems compared to those without the condition, though the risk is much higher in severe cases.

3. How Often Should Psoriasis Patients Be Checked for Heart Problems?

Patients with moderate to severe psoriasis should have yearly checks for blood pressure, cholesterol, blood sugar, and other heart health tests.

4. Are Children with Psoriasis at Risk for Heart Disease?

Yes, but the risk is generally lower than in adults. However, children with severe or long-standing psoriasis may still face higher cardiovascular risk later in life.

References

1. Nair PA, Badri T. Psoriasis. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 [cited 2025 Sep 6]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK448194/
2. Rendon A, Schäkel K. Psoriasis pathogenesis and treatment. Int J Mol Sci [Internet]. 2019 Mar 23 [cited 2025 Sep 9];20(6):1475. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6471628/ 
3. Constantin MM, Ciurduc MD, Bucur S, Olteanu R, Ionescu RA, Constantin T, et al. Psoriasis beyond the skin: Ophthalmological changes (Review). Exp Ther Med [Internet]. 2021 Sep [cited 2025 Sep 10];22(3):981. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8311223/
4. Gupta A, Madke B. Psoriasis a cause of cardiovascular diseases: a review article. Cureus [Internet]. [cited 2025 Sep 6];14(8):e27767. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9449340/
5. Martinez-Moreno A, Ocampo-Candiani J, Garza-Rodriguez V. Psoriasis and cardiovascular disease: a narrative review. Korean J Fam Med [Internet]. 2021 Sep [cited 2025 Sep 9];42(5):345–55. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8490176/
6. Mehta H, Narang T, Dogra S, Handa S, Hatwal J, Batta A. Cardiovascular considerations and implications for treatment in psoriasis: an updated review. Vasc Health Risk Manag [Internet]. 2024 May 10 [cited 2025 Sep 9];20:215–29. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11093123 

Disclaimer:
The information provided on this website is for general educational and informational purposes only. It is not intended to replace professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

Published September 11, 2025