Cardiovascular Mortality in Psoriasis and Psoriatic Arthritis: Epidemiology, Pathomechanisms, Therapeutic Implications, and Perspectives

被引:52
作者
Boehncke, Wolf-Henning [1 ]
Boehncke, Sandra [2 ]
机构
[1] Goethe Univ Frankfurt, Dept Dermatol, D-60590 Frankfurt, Germany
[2] Goethe Univ Frankfurt, Dept Internal Med, Sect Endocrinol Diabet & Metab, D-60590 Frankfurt, Germany
关键词
Psoriasis; Psoriatic arthritis; Myocardial infarction; Cardiovascular disease; Mortality; Epidemiology; Endothelial dysfunction; Insulin resistance; Inflammation; Adipokines; Adiponectin; Leptin; Resistin; Biomarkers; Therapy; Pathomechanisms; Risk factors; IMPAIRED ENDOTHELIAL FUNCTION; CHRONIC PLAQUE PSORIASIS; C-REACTIVE PROTEIN; MYOCARDIAL-INFARCTION; CORONARY-ARTERY; VASCULAR-DISEASES; RISK; INSULIN; EXPRESSION; ATHEROSCLEROSIS;
D O I
10.1007/s11926-012-0260-8
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Psoriasis and psoriatic arthritis are associated with an increased cardiovascular mortality. Although the underlying pathogenesis is not yet fully understood, it is clear that these seemingly organ-specific disorders cause a systemic inflammatory burden as mirrored by elevated bio-markers in the patients' blood. Emerging evidence points toward insulin resistance and endothelial dysfunction as direct consequences; these in turn drive the process of atherosclerosis. As psoriasis and psoriatic arthritis therefore represent cardiovascular risk factors, they must be taken into account by primary care physicians when defining treatment goals for the comorbidities of the respective patients (e.g., arterial hypertension or dyslipidemia). Secondary and tertiary care physicians need to consider a more comprehensive treatment approach, including aspects of lifestyle intervention. Finally, effective long-term anti-inflammatory, disease-modifying therapy may contribute to reducing patients' cardiovascular risk.
引用
收藏
页码:343 / 348
页数:6
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