PSORIASIS AND SUBCLINICAL CARDIOVASCULAR RISK: SKIN PLAQUES, ARTERIAL PLAQUES?

Abstract

DOI: https://doi.org/10.46296/yc.v9i17.0732

Abstract

Psoriasis is a systemic inflammatory disease linked to an increased cardiovascular (CV) risk, suggesting that disease-related systemic inflammation accelerates subclinical atherogenesis. Objective: To review current evidence on the association between psoriasis and subclinical CV risk—highlighting shared immunologic mechanisms, subclinical atherosclerosis, risk factors, and treatment effects. Methods: Critical appraisal of studies (2015–2025) published in English or Spanish and retrieved from high-impact databases. Results: Patients with psoriasis—especially those with moderate-to-severe disease—exhibit greater carotid intima-media thickness and a higher burden of subclinical atherosclerotic plaques than matched controls. The excess risk is partly attributable to the high prevalence of metabolic syndrome, obesity, hypertension, and dyslipidemia in psoriasis, but also to low-grade systemic inflammation driven by cytokines such as TNF, IL-17, and IL-6, which foster atherogenesis. Imaging modalities confirm an increased load of non-calcified coronary plaque and heightened arterial inflammation on PET/CT in psoriatic cohorts. Systemic immunomodulatory therapy appears to dampen vascular inflammation and may lower CV event rates, although randomized controlled trials have yet to demonstrate a significant reduction in hard outcomes. Conclusions: Psoriasis confers elevated subclinical CV risk through inflammatory pathways shared with atherosclerosis. Comprehensive care should include strict management of traditional risk factors and recognition of chronic inflammation as an additional risk determinant. Effective control of psoriatic disease may translate into vascular benefits, but further research is needed to confirm its impact on event reduction.

Keywords: psoriasis, atherosclerosis, cardiovascular risk, Inflammation, Comorbidity.