Patients with psoriasis should be screened for cardiovascular disease (CVD). The American Academy of Dermatology and National Psoriasis Foundation (AAD/NPF) 2019 guidelines recommend screening for hypertension, diabetes, and hyperlipidemia in all patients with psoriasis according to national guidelines
Cardiovascular disease screening recommendations
- Hypertension: The AAD/NPF 2019 guidelines recommend checking blood pressure in patients with mild, moderate, or severe psoriasis according to national guidelines. Patients with a blood pressure of ≥ 140/90 mmHg should be referred to their primary care provider for assessment and treatment
- Diabetes and hyperlipidemia: The guidelines recommend obtaining early and more frequent screening for these conditions in patients with psoriasis who are candidates for systemic or phototherapy or in patients with an involvement of > 10% of the body surface area
- Cardiovascular risk assessment: The guidelines recommend assessing cardiovascular risk by introducing a 1.5 multiplication factor to risk score models for patients with psoriasis who meet either of the following criteria: disease severity of body surface area > 10% or candidate for systemic or phototherapy
- Management of cardiovascular risk: The guidelines recommend managing cardiovascular risk in psoriasis for hypertension and dyslipidemia according to national guidelines. A target for blood pressure and lipid levels should be set based on the risk calculated for psoriasis
Metabolic syndrome screening recommendations
- Lipid tests: The AAD/NPF 2019 guidelines recommend obtaining lipid tests in all patients with psoriasis according to national guidelines by their healthcare provider. Consider screening with increased frequency in patients with severe disease
- Obesity status: The guidelines recommend determining the obesity status in patients with moderate-to-severe psoriasis according to national guidelines
- Metabolic syndrome status: The guidelines recommend evaluating metabolic syndrome status according to national guidelines by an appropriate healthcare professional
In conclusion, patients with psoriasis should be screened for cardiovascular disease and metabolic syndrome according to national guidelines. This is due to the increased risk of cardiovascular disease in this patient population, particularly those with moderate to severe disease
. Regular follow-up and monitoring are essential to manage both psoriasis and associated cardiovascular risks effectively.