PSORIASIS AND HEART DISEASE
Psoriasis of Elbows
We have all seen people with PSORIASIS. It is not an uncommon disease. Since it primarily attacks the skin, it is easy to recognize. Unfortunately, it does not only attack the skin. We have just recently learned that Psoriasis also attacks the heart. According to a team headed by Dr. Ole Ahlehoff of Denmark, we now learn that patients with Psoriasis have a markedly increased chance of having Heart Disease as well.
Dr. Ole Ahlehoff
Presenting his data at a press conference at the American College of Cardiology 2010 Scientific Sessions, Ahlehoff explained that the association between psoriasis and heart disease has been suggested before, but the results have been ambiguous and debated and the clinical relevance doubted.
We know that PSORIASIS is an INFLAMMATORY DISEASE. The term Inflammatory Disease is relatively new in Medicine, making its appearance about twenty years ago. Medical science has always known about Inflammation (which means “to set on fire”) however, physicians did not ascribe the term to general diseases, such as Heart Disease or Intestinal Disease or chronic diseases of organs of the body.
Inflammation was thought of as a local reaction to the injury or infection of one area or one organ. However, in the late 1980′s doctors, around the world, took note that the entire body was inflamed when a patient had heart disease.
Inflammation is a result of the Immune System being aroused and sending in to the area of arousal, those cells that cause blood to flow faster and the “soldier cells” of the immune system to gather and attack the enemy. The enemy was almost always, viruses or bacteria that were attacking an organ of the body.
C REACTIVE PROTEIN
The primary marker of inflammation in the body is a protein called: C REACTIVE PROTEIN. If there are higher levels of C Reactive Protein in the blood, than we can say that inflammation is present.
Instead of the usual markers of heart disease, such as heart enzymes, EKG’s and levels of lipids and cholesterol, doctors were soon ordering C Reactive Protein to determine whether inflammation was playing a role in their patients heart and arteries.
Here is the definition from the Mayo Clinic:
C-reactive protein (CRP) is a normal protein that can be measured in the blood. It appears in higher amounts when there’s swelling somewhere in your body. Your doctor may check your C-reactive protein level after surgery or treatment for infections or other medical conditions. The C-reactive protein test can also be used to check your risk of developing coronary artery disease, a condition in which the arteries of your heart are narrowed. Coronary artery disease can eventually lead to a heart attack.
You can see that inflammation became to be recognized as a state of readiness by the immune system, preparing the heart and arteries for a possible heart attack. Now, we are seeing that the heart and arteries (the cardio-vascular system) are inflamed if the patient has a skin that is also inflamed. The Immune System is ready to defend the Cardio-Vascular System as well as the Skin.
OR, IS THE IMMUNE SYSTEM THE CAUSE OF BOTH HEART AND SKIN DISEASE?
No one really knows the cause of Psoriasis. There is clearly a genetic component to its cause, because unless certain tissue types are available, Psoriasis will not appear.
Also, the treatment of psoriasis is following the treatment of other auto-immune diseases. The best treatment so far, is by the use of antibodies which attack cells of the immune system. If the Immune System is the cause of Psoriasis and its inflammation, it must also be possible that the immune system is the cause of heart disease.
Why would our Immune System attack our heart? As a matter of fact, why does our Immune System attack specific cells of our body, such as our nervous system in Multiple Sclerosis; our Thyroid Gland as in Hashimoto’s and Grave’s Diseases; our Muscles as in Polymyositis—and on and on.
Our Immune System, supposedly our strongest defender, can also be our greatest enemy! For some strange reason, our Immune System, can and does attack any part of our body, given the right precipitating factors. In the case of Psoriasis, our supposed friend the Immune System winds up attacking our heart.
Here is the article from MedScape, the doctor’s website:
Psoriasis “Firmly Established” as Risk Factor for CV Disease
By Sue Hughes
March 14, 2010 (Atlanta, Georgia) — A new study “firmly establishes” that psoriasis is a risk factor for heart disease, the authors say.
“Physicians should think of psoriasis patients, particularly those with severe psoriasis, as a group at increased cardiovascular risk, and they should be prioritized for lifestyle changes and screening for dyslipidemia and hypertension and considered for earlier medical risk-factor intervention for heart disease,” lead investigator Dr Ole Ahlehoff (Copenhagen University Hospital, Denmark) said.
Presenting his data at a press conference at the American College of Cardiology 2010 Scientific Sessions, Ahlehoff explained that the association between psoriasis and heart disease has been suggested before, but the results have been ambiguous and debated and the clinical relevance doubted.
For the current study, Ahlehoff and colleagues tracked rates of psoriasis, atrial fibrillation, stroke, MI, PCI, and death in the entire adolescent and adult population of Denmark between 1997 and 2006. They looked at the incidence of cardiac events in 40 000 patients with mild to severe psoriasis and compared the results with those in four million people without psoriasis.
They found that patients with severe psoriasis were more likely to experience all of the adverse cardiac events tracked and patients with mild psoriasis were more likely to experience atrial fibrillation, stroke, and PCI, even after adjustment for other risk factors.
The increased risk of two events–atrial fibrillation and stroke–was found to be age-dependent, with the risk in patients with moderate/severe psoriasis higher in those who were younger than 50 years old at the beginning of the study in 1997.
These novel findings, including the higher risk for younger patients, indicate that psoriasis patients should not only be treated for the symptoms of that disorder but should also take steps to monitor and prevent cardiovascular problems, the authors said.
“I believe that our results call for increased awareness of psoriasis as a contributor to cardiovascular disease and for a discussion of future medical management,” Ahlehoff said. “For example, should patients with psoriasis receive statin therapy earlier than predicted by traditional risk scores? Since psoriasis is a common disease, affecting 2% to 3% of people worldwide, reducing cardiovascular risk in this large group of patients could have a considerable impact.”
Ahlehoff told heartwire that the mechanism behind this association is believed to be coincident inflammation. “Both psoriasis and atherosclerosis are inflammatory diseases, and they probably have a large overlap in markers and mediators,” he said.
SUMMARY
We see that Psoriasis, an auto-immune disease, cause pathology in the Cardio-Vascular System of patients with this skin disease. This leads us to the question: Why does our immune system attack many parts of our body? Our Immune System may see us as more than just cells and tissues.
It may recognize us as a totality, body and mind, and attack if there is an imbalance. The ultimate solution to this puzzle remains to be found.
