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Psoriasis and Heart Disease: The Hidden Connection

Psoriasis and Heart Disease: The Hidden Connection
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Updated on March 18, 2025
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Psoriasis attacks healthy cells, causing inflammation that leads to plaques and other skin changes. Some of the same underlying triggers that drive psoriasis may also pose problems for your heart.

Psoriasis increases inflammation throughout the body, including the cardiovascular system. “Chronic inflammation has long been associated with an increased risk of heart attack and stroke,” says Kevin Campbell, MD, a cardiologist at Health First Medical Group in Melbourne, Florida.

Keep reading to understand the relationship between psoriasis and heart disease.

The Link Between Psoriasis and Heart Disease

There is strong evidence linking severe psoriasis with heart disease, but the exact relationship between the two conditions is still unclear. There are several reasons psoriasis may increase the risk of heart disease.

Genetic Risk

“Psoriasis shares some common factors with heart disease, including genetic relationships”, says Joel Gelfand, MD, director of the Psoriasis and Phototherapy Treatment Center at Penn Medicine in Philadelphia and coauthor of numerous studies on the link between psoriasis and heart disease.

Some genes are linked to both psoriasis and heart disease. A study that looked at genetic risk for heart disease and immune function diseases found genetic predictors of coronary artery disease and stroke were significantly associated with psoriasis risk.

Inflammatory Pathways

Although this is still an area of active research, some experts believe that both conditions may share inflammatory pathways that drive the progression of heart disease and cause psoriasis plaques.

Inflammation can damage arteries, which results in the formation of blockages or plaques inside the blood vessels that supply blood to the heart muscle.

“Although psoriasis plaques are different from plaques in the arteries, the inflammation that makes the skin red and flaky is a similar kind of inflammation that causes blockages in the arteries,” says Dr. Gelfand. “The more skin that is involved with psoriasis, the higher the risk is of developing diabetes and cardiovascular disease.”

Pro-inflammatory Proteins

Psoriasis is linked with issues in the body’s fat tissue. Adipokines, resistin, and leptin are proteins released by fat cells that impact inflammation and heart health. People with psoriasis often have increased levels of these pro-inflammatory substances.

The differences in the fat tissue in people with psoriasis is associated with an increased risk of metabolic syndrome, a group of cardiovascular risk factors including obesity and fat tissues around the midsection, high cholesterol and glycerides, and high blood pressure.

Insulin Resistance

Insulin resistance is when the body doesn’t respond to insulin the way that it should, so it can’t properly process sugar and fats.

Research suggests that the inflammatory proteins involved in insulin resistance are often dysregulated in people with psoriasis.

The blood sugar buildup caused by insulin resistance can lead to type 2 diabetes, which increases the risk of heart disease.

Cholesterol Buildup

Psoriasis is linked with abnormal cholesterol and triglycerides, which are types of lipoproteins.

People with psoriasis often have low HDL (high-density lipoprotein, also known as “good” cholesterol) levels and high triglyceride and LDL (low-density lipoprotein, or “bad” cholesterol) levels, which are risk factors for heart disease.

Risk Factors and Life Expectancy for Psoriasis and Heart Disease

“People with psoriasis have about a 50 percent higher risk of heart attack and stroke, independent of traditional risk factors,” says Gelfand.

This is because compared with people without psoriasis, people with psoriasis are more likely to have high blood pressure, diabetes, obesity, and high cholesterol, all of which are risk factors for heart disease.

Making matters worse, patients with psoriasis are less likely to have these risk factors identified and adequately treated, Gelfand says.

“People with psoriasis that is severe enough to require pills, phototherapy, or biologics have a five-year reduction in life expectancy, the majority of which is due to excess risk of cardiovascular disease,” he says. “And unfortunately, many people with psoriasis are unaware that the connection between the two conditions exists.”

Treatment for Psoriasis and Heart Disease

There is some evidence that some medications typically prescribed for moderate to severe psoriasis may improve cardiovascular health.

Medications that may lower the risk of heart attack and stroke include:

Methotrexate

First approved in the 1970s, methotrexate (Jylamvo, Trexall, Xatmep) is a systemic medication that suppresses the immune system to reduce inflammation and prevent the rapid growth of skin cells.

Biologics

TNF inhibitors, such as adalimumab (Humira) are prescribed to treat several inflammatory and autoimmune conditions, including psoriasis. They belong to a group of medicines called biologics.

These protein-based medicines are made from the cells of living organisms and work by targeting specific parts of the immune system that are overactive in psoriasis.

Studies have shown biologics are an effective psoriasis treatment for some people.

Ustekinumab (Stelara)

Ustekinumab (Stelara) is used to treat moderate to severe psoriasis. It works by targeting and blocking the action of interleukin-12 (IL-12) and interleukin-23 (Il-23). Il-12 and IL-23 are both types of cytokines, the chemical messengers produced by cells, and are both involved in psoriasis activity.

Ustekinumab is administered by injection under the skin and has been shown to produce good to excellent results in more than two-thirds of cases.

How to Reduce Your Risk of Heart Disease and Psoriasis

While you may not be able to control when you have a psoriasis flare or whether the attack will be mild or severe, there are steps you can take to both manage your psoriasis and protect your heart health.

“If you have psoriasis, you not only need to treat the symptoms of the skin disorder, but also change your lifestyle to adhere to a daily program that will minimize your risk of cardiovascular problems,” says Steven Victor, MD, a dermatologist and the director of Victor Regenerative Medical Centers in New York City and Dubai.

Follow these steps to help you both manage psoriasis symptoms and prevent heart disease.

Take Your Medications as Prescribed

Effective treatment of psoriasis can help manage skin symptoms and keep inflammation under control.

Not only could this potentially reduce the risk of heart disease, but it may also help prevent psoriatic arthritis and mental health issues.

If you also have high blood pressure, high cholesterol, or diabetes, your doctor may prescribe medications to help manage those conditions to lower the risk of heart disease.

Eat a Healthy Diet

Diet can’t cure or prevent psoriasis, but it can reduce psoriasis symptoms and the risk of comorbidities, including heart disease.

If you have psoriasis and want to reduce your risk for heart disease, experts recommend that you:

  • Maintain a healthy weight
  • Exercise regularly
  • Limit fried and highly processed foods
  • Focus on eating whole grains and plenty of fruits and vegetables
  • Limit alcohol

Quit Smoking

Smoking is known to increase the risk for heart disease. It also increases the risk of having psoriasis flares.

If you’re struggling to quit smoking, you can try nicotine replacement therapy or talk to your doctor about getting help.

Keep an Open Dialogue With Your Care Team

“Your healthcare providers are looking out for your best interests. Regular checkups are critical,” says Dr. Victor.

Your doctor can monitor your heart health during regular checkups by taking blood pressure readings and checking your cholesterol and triglyceride levels.

To manage your risk for the best possible outcomes, collaboration between your primary care doctor, dermatologist, and cardiologist is recommended.

The Takeaway

  • Psoriasis and heart disease are linked through shared genetic factors and inflammatory pathways, which can contribute to an increased risk of heart attack and stroke.
  • The risk of cardiovascular issues is higher for individuals with psoriasis, particularly if it is severe enough to require medication or treatment with biologics.
  • A healthy lifestyle that includes regular physical activity, a balanced diet, quitting smoking, and taking medications as prescribed can help reduce the risk of heart disease and manage psoriasis symptoms.

Resources We Trust

EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Resources
  1. Ramessur R et al. Exploring the Link Between Genetic Predictors of Cardiovascular Disease and Psoriasis. JAMA Cardiology. September 18, 2024.
  2. Piaserico S et al. Psoriasis and Cardiometabolic Diseases: Shared Genetic and Molecular Pathways. International Journal of Molecular Sciences. August 13, 2022.
  3. Mehta H et al. Cardiovascular Considerations and Implications for Treatment in Psoriasis: An Updated Review. Vascular Health and Risk Management. May 10, 2024.
  4. Kim JE et al. The Roles and Associated Mechanisms of Adipokines in Development of Metabolic Syndrome. Molecules. January 6, 2022.
  5. Parraga SP et al. Insulin Resistance and Psoriasis. British Journal of Dermatology. May 13, 2024.
  6. Shih CM et al. The Roles of Lipoprotein in Psoriasis. International Journal of Molecular Sciences. January 29, 2020.
  7. Garshick MS et al. Cardiovascular Risk in Patients with Psoriasis. Journal of the American College of Cardiology. April 6, 2022.
  8. Psoriasis Treatment: Biologics. American Academy of Dermatology Association. August 22, 2024.
  9. Ranaweera A. Ustekinumab for psoriasis. Dermnet. April 2019.
  10. Why Treat? National Psoriasis Foundation.
  11. Psoriasis and Diet: How Foods Can Impact Inflammation. Cleveland Clinic.
  12. Are Triggers Causing Your Psoriasis Flare-Ups. American Academy of Dermatology Association.
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Beth Biggee, MD

Medical Reviewer

Beth Biggee, MD, is medical director and an integrative rheumatologist at Rheumission, a virtual integrative rheumatology practice for people residing in California and Pennsylvania. This first-of-its-kind company offers whole person autoimmune care by a team of integrative rheumatologists, lifestyle medicine practitioners, autoimmune dietitians, psychologists, and care coordinators.

Dr. Biggee also works as a healthcare wellness consultant for Synergy Wellness Center in Hudson, Massachusetts. Teamed with Synergy, she provides in-person lifestyle medicine and holistic consults, and contributes to employee workplace wellness programs. She has over 20 years of experience in rheumatology and holds board certifications in rheumatology and integrative and lifestyle medicine. Dr. Biggee brings a human-centered approach to wellness rather than focusing solely on diseases.

Dr. Biggee graduated cum laude with a bachelor's degree from Canisius College, and graduated magna cum laude and as valedictorian from SUNY Health Science Center at Syracuse Medical School. She completed her internship and residency in internal medicine at Yale New Haven Hospital, completed her fellowship in rheumatology at Tufts–New England Medical Center, and completed training in integrative rheumatology at the University of Arizona Andrew Weil Center for Integrative Medicine. Following her training, she attained board certification in rheumatology and internal medicine through the American Board of Internal Medicine, attained board certification in integrative medicine through the American Board of Physician Specialties, and attained accreditation as a certified lifestyle medicine physician through the American College of Lifestyle Medicine. She is certified in Helms auricular acupuncture and is currently completing coursework for the Aloha Ayurveda integrative medicine course for physicians.

In prior roles, Dr. Biggee taught as an assistant clinical professor of medicine at Mary Imogene Bassett Hospital (an affiliate of Columbia University). She was also clinical associate of medicine at Tufts University School of Medicine and instructed "introduction to clinical medicine" for medical students at Tufts. She was preceptor for the Lawrence General Hospital Family Medicine Residency.

Dr. Biggee has published in Annals of Rheumatic Diseases, Arthritis in Rheumatism, Current Opinions in Rheumatology, Journal for Musculoskeletal Medicine, Medicine and Health Rhode Island, and Field Guide to Internal Medicine.

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Becky Upham, MA

Becky Upham

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Becky Upham has been professionally involved in health and wellness for almost 20 years. She's been a race director, a recruiter for Team in Training for the Leukemia & Lymphoma Society, a salesperson for a major pharmaceutical company, a blogger for Moogfest, a communications manager for Mission Health, a fitness instructor, and a health coach.

She majored in English at the University of North Carolina and has a master's in English writing from Hollins University.

Upham enjoys teaching cycling classes, running, reading fiction, and making playlists.

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