If you have psoriasis, it is important to ensure your blood pressure remains well-controlled. Researchers who looked for health links among all people living in Denmark have found that adults with psoriasis are significantly more likely to develop a weakened bulge in the lining of the largest artery in the body (aortic aneurysm) than people without psoriasis.
Psoriasis and aortic aneurysm
Psoriasis is an inflammatory condition in which new skin cells are produced at a rate that’s around ten times faster than normal. As a result, they push up to the surface faster than the dead cells they are designed to replace can fall away. Live cells accumulate and form characteristic raised, red patches covered with dead cells forming fine, silvery scales.
Psoriasis symptoms can include the appearance of bright red, scaly patches that vary in size from a few millimetres to extensive plaques. Most usually the elbows, knees, flexures, scalp and lower back are affected. Thickening and pitting of the nails is common, and between 10% and 30% of people with psoriasis develop joint symptoms known as psoriatic arthritis.
Psoriasis affects between 2% and 3% of the population. Average age of onset is 28 years, but around one in ten cases start in children under ten years. It is usually a lifelong condition with flare-ups and remissions.
The risk of aortic aneurysm increases with the severity of psoriasis symptoms so that, in this study, people with mild psoriasis were 20% more likely to develop an abdominal aortic aneurysm, and people with severe psoriasis were 67% more likely to develop an abdominal aortic aneurysm than those with normal skin.
What causes the link between psoriasis and aortic aneurysm?
The exact cause of psoriasis is unknown, but genetic, immune and environmental factors are all involved. Skin lesions are associated with infiltration of immune cells (activated T-cells) which secrete inflammatory factors such as TNF-alpha, that cause skin cells to proliferate. Now it seems that raised levels of these inflammatory factors throughout the circulation also hastens hardening and furring up of artery linings (atherosclerosis).
Now that a link between psoriasis and aortic aneurysm has been identified, it’s important for people with this skin condition to keep other cardiovascular/aneurysm risk factors to a minimum. Do your utmost to ensure your blood pressure and cholesterol balance are well-controlled and, if you have diabetes, aim to keep your glucose levels within the normal range as much as possible.
Smoking and alcohol can trigger flare-ups and are best avoided.
Psoriasis and diet
Some people with psoriasis find their skin improves if they cut back on eating red meat, dairy products, eggs, gluten, refined sugars and saturated fats. This approach is similar to that of the DASH Diet for hypertension.
However, if you plan to follow a restricted diet for more than a few weeks, seek nutritional advice to avoid vitamin and mineral deficiencies.
Some nutritional therapists recommend taking milk thistle and globe artichoke extracts to reduce liver synthesis of inflammatory chemicals. This may improve the rate at which new skin cells are produced, but has not been researched to any great extent.
Psoriasis has been linked with abnormalities in essential fatty acid metabolism.
Omega-3 fish oil supplements have an anti-inflammatory effect which helps to damp down psoriasis lesions, improving itching, scaling and redness. As a bonus, omega-3 fish oils have a beneficial effect on blood pressure, too.
Vitamin D is important for skin health and supplements are effective in some forms of psoriasis – so much so that vitamin D analogues are used in many prescribed topical treatments. Supplements may also improve metabolic risk factors for heart disease and diabetes in people with psoriasis, as well have having beneficial effects on blood pressure.
Turmeric is a natural herbal remedy that can block the effects of TNF-alpha in a similar way to some prescribed medications. Turmeric has been shown to improve plaque psoriasis in some people at relatively high doses, although more research is needed to confirm these effects.
If your blood pressure is raised, self-monitoring is key to maintaining good control.
Click here for advice on choosing a blood pressure monitor to use at home.
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