How Is Psoriatic Arthritis Linked to Cardiovascular Disease?
Reviewed by: HU Medical Review Board | Last reviewed: August 2022 | Last updated: March 2023
People with psoriatic arthritis (PsA) are at increased risk for cardiovascular disease, also known as heart disease. In fact, research shows that people with PsA are 43 percent more likely to develop heart disease than people who do not have PsA.1
Systemic inflammation is a cornerstone symptom of PsA. It affects all areas of the body. It can cause insulin resistance and upset the lining of the blood vessels, which can lead to abnormal fatty masses forming in the arteries (atherosclerosis). Atherosclerosis can then lead to major cardiovascular events like heart attack and stroke.1,3
Heart disease remains the number 1 cause of death in the United States. It is critical to know your risk factors and take steps to reduce your risk.2
Risk factors for heart disease with PsA
There are several factors that link PsA with heart disease. These factors include:1
- Genetic risk factors
- Environmental risk factors
- Other health conditions
Genetic risk factors
A family history of heart disease can predispose someone to high blood pressure, heart disease, and other conditions. This is a hereditary risk factor that a person cannot change.3
Lifestyle risk factors
Lifestyle risk factors that are known to increase the risk of heart disease include:1,2
- Smoking – Smoking increases inflammation in the body and can make PsA symptoms worse. Smoking also makes some PsA medicines less effective.
- Inactivity – A sedentary lifestyle is not good for anyone. Staying active and moving a little bit every day can cut your risk of heart disease in half. For people with PsA, this is extra important since regular movement keeps joints mobile and flexible.
- Unhealthy diet – Too much processed food can raise your cholesterol, increase inflammation, and lead to an unhealthy weight.
Other health conditions
Other health conditions that have been linked to an increased risk for heart disease include:1,2
- Type 2 diabetes
- High blood pressure (hypertension)
People with PsA are more likely to have these other health conditions. This further raises their risk for a major cardiovascular event such as a heart attack or stroke.1
Some research suggests that treating PsA with TNF inhibitor drugs may reduce the risk of heart disease. TNF stands for tumor necrosis factor, which is a substance that can cause inflammation in the body. It makes sense that blocking TNF would decrease inflammation that could lead to heart disease. However, there is not much data that proves this finding. More research is needed.1
While non-steroidal anti-inflammatory drugs (NSAIDs) are often prescribed for people with PsA, these drugs can increase the risk of heart disease and stroke. Tell your doctor about all of your health concerns. Together, you can create a treatment plan that takes into account your overall health.1
Ways to decrease your risk of heart disease
Just like the general population, people with PsA can decrease their risk of heart disease by managing certain risk factors:1-5
- Do not smoke. Smoking is the most preventable cause of premature death in the United States. Smoking increases the risk of heart disease and stroke. It can also make PsA medicines less effective.
- Treat high blood pressure. Hypertension puts more stress on your arteries and can cause damage over time.
- Treat high cholesterol. High cholesterol is one of the major controllable risk factors for heart disease. When too much low-density lipoprotein (LDL), or “bad” cholesterol, is in the blood, it can build up in the artery walls. This narrows the vessels that feed the heart and other organs.
- Control diabetes. Diabetes affects many major organs in the body, including the heart. Diabetes can be managed with a healthy diet and exercise.
If you have PsA, consider these lifestyle changes to improve your overall heart health:1,2,4
- Lose weight if needed
- Increase physical activity
- Eat a healthy, well-balanced diet
- Decrease alcohol consumption if you consume excessively