Psoriasis und kardiovaskuläre Erkrankungen

The concept of the psoriasis march suggests that chronic skin inflammation leads to systemic inflammation, which, in conjunction with increased oxidative stress, triggers a cascade of events. These include oxidative stress, dyslipidemia, endothelial dysfunction, and insulin resistance, which contribute to metabolic syndrome or its individual components and an increased risk of cardiovascular complications in psoriasis patients. An increase in plasma lipid and lipoprotein levels, along with disturbances in triglyceride oxidation and cholesterol levels, particularly low-density lipoprotein, promotes the formation of atherosclerotic plaques and predisposes psoriasis patients more than control subjects to atherosclerosis. Oxidative stress also contributes to inflammatory processes that lead to increased oxidative burden, cell damage, and lipid peroxidation of cell membranes. Thus, severe psoriasis appears to be an independent risk factor for cardiovascular diseases and significant adverse cardiac outcomes such as heart attack, stroke, and cardiovascular mortality. The Framingham risk score predicts the likelihood of a heart attack in the next 10 years for adults aged 20 and older who do not have heart disease or diabetes.