Exploring the Relationship Between Hypertension and Psoriasis

People living with psoriasis are more prone to high blood pressure than the general population, said Joel Gelfand, MD, vice chair of clinical research and medical director of the dermatology department at Penn Medicine in Philadelphia.

An extensive analysis published in the Journal of Hypertension examined the medical records of over 300,000 individuals with psoriasis. The researchers found that high blood pressure affected 54 percent of patients with severe psoriasis symptoms.

A paper published in JAMA Dermatology also publicized evidence of individuals with moderate or severe psoriasis being more susceptible to uncontrolled blood pressure. According to Dr. Gelfand, the more skin areas become covered in psoriasis lesions, the more likely it is for hypertension to arise.

Risk Factors and Mechanisms Behind the Psoriasis-Hypertension Link

Clinical researchers suggest that psoriasis and high blood pressure share the following risk factors, contributing to their co-occurrence:

• Inflammation and immune system dysregulation: Chronic inflammation is one of the main culprits behind psoriasis and hypertension. The immune system dysfunction observed in psoriasis can also lead to systemic inflammation, which may impact blood pressure regulation.
• Lifestyle factors: Smoking, excessive alcohol consumption, poor dietary habits, and a sedentary lifestyle can worsen psoriasis and increase the risk of high blood pressure.
• Genetic predisposition: Certain genetic components can make psoriasis and high blood pressure run in families.

Role of Chronic Inflammation in Psoriasis and High Blood Pressure

Chronic inflammation is a hallmark feature of psoriasis. It is also implicated in the pathogenesis of elevated blood pressure levels.

In psoriasis, inflammatory cells and pro-inflammatory cytokines contribute to skin lesion development. These same inflammatory mediators can impact blood vessel function, leading to endothelial dysfunction and subsequent hypertension.

Allow us to explain how these mechanisms can build a bridge between high blood pressure and psoriasis:

• Cytokines: Inflammatory cytokines, such as tumor necrosis factor-alpha (TNF-alpha) and interleukin-6 (IL-6), are high in people with both conditions. These cytokines can promote inflammation, endothelial dysfunction, and vascular remodeling, contributing to hypertension progression.
• Endothelial dysfunction: Psoriasis-related inflammation can disrupt endothelial function, impairing the ability of blood vessels to dilate and regulate blood flow. Endothelial dysfunction is a common attribute in psoriasis and high blood pressure, further linking the conditions.
• Oxidative stress: Oxidative stress, which an imbalance between reactive oxygen species and antioxidant defense mechanism characterize, is present in psoriasis and high blood pressure alike. Oxidative stress can induce inflammation, vascular dysfunction, and hypertension.

Understanding these factors and mechanisms can provide insights into the correlation between psoriasis and high blood pressure, opening up possibilities for targeted therapeutic approaches that address both conditions. However, further research is necessary to elucidate their complex interactions and establish more effective management strategies.

Quality of Life and Mental Health Implications of Psoriasis and Hypertension

The impact of psoriasis and high blood pressure goes beyond physical health. The visible nature of psoriasis skin lesions and the challenges associated with managing these health problems can take a toll on anyone’s quality of life. The psychosocial burden of coping with the symptoms, treatments, and potential complications can also prompt or worsen stress, anxiety, and depression, affecting mental health and overall well-being.

Management and Treatment Strategies

Managing psoriasis and high blood pressure entails a comprehensive approach that addresses each condition, all while considering their interplay.

1. Lifestyle Modifications

Presented below are strategies for managing and treating these conditions through lifestyle improvements:

• Healthy diet: Patients can lower blood pressure and reduce heart attack risk by following a balanced diet rich in leafy vegetables, whole grains, and lean proteins. They should also limit or eliminate sodium, saturated fats, and processed foods from their diet.
• Weight management: Excess weight can exacerbate high blood pressure and psoriasis symptoms. Therefore, achieving and maintaining a healthy weight through regular physical activity is crucial for overweight individuals diagnosed with either or both conditions.
• Stress reduction techniques: Stress management techniques such as meditation, deep breathing exercises, yoga, or engaging in hobbies can help mitigate the impact of stress on psoriasis and blood pressure.

2. Medications and Therapeutic Approaches

Outlined are vital methods involving medications and therapeutic strategies for the management and treatment of these health conditions:

• Antihypertensive medications: Seek appropriate antihypertensive prescriptions tailored to individual needs and consider the potential effects on psoriasis. Some antihypertensive medications, such as angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs), may have additional benefits for psoriasis patients due to their anti-inflammatory properties.
• Psoriasis-specific treatments with blood pressure benefits: Consider psoriasis treatments that may have a positive impact on blood pressure control. For instance, certain systemic medications, such as biologics or methotrexate, have the potential to improve blood pressure regulation.

3. Regular Monitoring and Collaboration

Highlighted below are essential aspects of regular monitoring and collaboration, crucial for managing and addressing these conditions:

• Patient education: Those with either or both conditions must expand their knowledge of the connection between high blood pressure and psoriasis, empowering them to be proactive in their own care.
• Interdisciplinary care: Close collaboration between cardiologists and Arizona Skin dermatologists can help patients develop a management plan that addresses high blood pressure and psoriasis. A novel approach detailed in a 2022 investigation published in JAMA Dermatology proposes a system whereby individuals with psoriasis and early signs of heart disease would be referred by their dermatologist to a dedicated care coordinator. The care coordinator would assist in mitigating these risk factors and facilitate connections with primary care providers.

The Bottom Line

Research shows an indisputable association between psoriasis and increased proteins and enzymes that trigger inflammation or raise blood pressure levels. Managing these conditions demands a personalized approach, one that considers individual patient characteristics and the severity of each condition. Lifestyle modifications, seeking treatment, patient engagement, and ongoing communication between healthcare professionals are crucial to achieving optimal outcomes and improving overall health.

Make an Appointment at Arizona Skin

Patients should remember to consult a healthcare specialist for appropriate treatment based on their unique circumstances. If you need a psoriasis treatment specialist in the Greater Phoenix area including Surprise, Buckeye or Scottsdale, drop us a line to schedule a consultation. Our dermatologists, unmatched experts in the science of skin care and beauty, can also work with your cardiologist to address all health concerns with safety and accuracy.