Psoriatic arthritis (PsA) is an inflammatory disease of the joints. It causes stiffness, pain, and swelling in the joints. Most of the time, people with PsA have psoriasis, which causes red, scaly patches on the skin.

But the impact of PsA goes beyond the joints and skin.

In recent years, researchers and doctors have discovered that PsA is linked to a variety of metabolic issues.

Specifically, people with PsA are more likely to develop heart disease. This puts people with PsA at a higher risk of heart attack, stroke, and death.

Research has shown that chronic inflammation from psoriasis can lead to cardiovascular disease.

Inflammation is a primary driver for atherosclerosis, which is the buildup of fat and cholesterol in artery walls. Over time, this buildup can lead to high blood pressure, heart attack, and stroke.

A 2014 study found that arthritis in one joint has a significant impact on heart health. The researchers found that people with PsA who had sacroiliitis, or inflammation of the sacroiliac joints connecting the spine and pelvis, were more likely to have cardiovascular issues. Inflammation in these specific joints was linked to more inflammation in the heart.

A 2016 review of studies with more than 32,000 patients found that people with PsA were 43 percent more likely to develop cardiovascular diseases compared to the general population.

In addition to the increased likelihood of heart disease, one study found that people with PsA are more likely to have traditional risk factors for heart disease, including obesity and diabetes. Combined with chronic inflammation from PsA, these factors can lead to damage to the blood vessels and arteries.

What’s more, another review of studies found that people with PsA are significantly more likely to have metabolic syndrome. Metabolic syndrome includes conditions that increase the risk for cardiovascular disease, including:

  • high blood pressure
  • high blood sugar
  • high triglycerides
  • high cholesterol levels
  • greater waist circumference

These cardiovascular impacts are most significant in people with moderate and severe PsA, not mild.

Someone with heart disease may not experience symptoms until the disease is already severe and potentially fatal. One study found that cardiovascular disease was the leading cause of death in people with PsA.

That’s why people with PsA should work with their doctors to identify potential risks and symptoms of heart disease before they progress.

These symptoms may include:

  • chest pressure
  • shortness of breath
  • tightness or discomfort in the chest
  • pain in the jaw, neck, or throat
  • pain in the upper abdomen or back
  • indigestion or heartburn
  • nausea
  • pain, numbness, or weakness in the legs or arms
  • feeling dizzy or lightheaded
  • fatigue

If you’re experiencing these symptoms, discuss them with your doctor. These symptoms are a sign that you could have heart disease or heart-related health issues.

It’s hard to measure the impact of inflammation on the body until it’s caused significant damage. Inflammation is difficult, but not impossible, to detect.

Regular testing and physicals with your doctor can help you address the heart-related impacts of PsA early on. It is important to monitor key indicators of heart health.

Monitor your heart health by testing for:

  • blood pressure
  • cholesterol
  • triglycerides
  • blood sugar
  • certain markers of inflammation

Traditional risk assessments for cardiovascular disease look at a person’s medical history and lifestyle to predict their risk of heart attack, stroke, and death. These assessments are not as useful for people with PsA because they do not factor in the impact of chronic inflammation.

In the future, more advanced testing to predict the risk of heart disease in people with PsA may be developed. Until then, people with PsA should make sure to regularly check on their heart health.

Newer research says treating PsA properly may help reduce the risk of cardiovascular disease.

One study found that people who had PsA and also took tumor necrosis factor (TNF) inhibitors, a type of treatment that targets specific inflammation markers, had a lower incidence of plaque buildup in their arteries.

In another study, patients with a low cardiovascular risk who were taking a biologic treatment had a 6 percent reduction in arterial plaque after 1 year of treatment. The researchers concluded this is likely the result of reduced inflammation.

Biologics are used to treat moderate or severe cases of PsA, and people with cases at this level are more likely to have greater indications of heart disease. Work with your doctor to find a treatment that both treats PsA and doesn’t increase the risk of heart issues. Properly treating PsA may help manage cardiovascular risk.

Certain lifestyle changes may also help treat both heart disease and PsA. These changes include:

  • If you smoke, consider quitting. Smoking increases inflammation, which adds to your risk of disease and accompanying symptoms.
  • Exercise regularly. Regular exercise may help people with PsA address the typical risk factors for heart disease like obesity, diabetes, and inactivity. Weight loss can also reduce stress on the heart and blood vessels and reduce inflammation. Speak with your doctor about beginning a safe exercise program if arthritis greatly impacts your mobility.
  • Maintain a balanced diet. The Mediterranean diet has been shown to reduce inflammation and help with weight maintenance. This diet includes many plant-based foods, fish rich in omega-3, and heart-healthy olive oil.

Psoriatic arthritis (PsA) doesn’t only affect the skin and joints. It can cause heart health problems, too.

People with PsA should carefully monitor their heart health with their doctor and treat any issues like high blood pressure, high cholesterol, and high blood sugar.

Properly treating PsA may reduce your risk for cardiovascular issues. Many other risk factors for heart disease, including obesity and smoking, can be managed or improved. It’s possible the same is true for PsA inflammation.

If you have PsA, work with your doctor to monitor for signs of heart health complications. Having PsA doesn’t mean you will have heart disease, but being aware of the risk keeps you one step ahead of potential health issues.