Cardiovascular Mortality in Psoriasis and Psoriatic Arthritis: Epidemiology, Pathomechanisms, Therapeutic Implications, and Perspectives
Cardiovascular Mortality in Psoriasis and Psoriatic Arthritis: Epidemiology, Pathomechanisms, Therapeutic Implications, and Perspectives
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DOI：
10.1007/s11926-012-0260-8
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发表时间：
2012-08-01
影响因子：
5
通讯作者：
Boehncke, Sandra
中科院分区：
文献类型：
--
作者：
Boehncke, Wolf-Henning;Boehncke, Sandra
银屑病和银屑病关节炎与心血管疾病死亡率增加有关。尽管潜在的发病机制尚不完全清楚，但很明显，这些看似器官特异性的疾病引起全身炎症负担，这反映在患者血液中生物标志物的升高上。新出现的证据指出胰岛素抵抗和内皮功能障碍是直接后果；这些反过来又推动了动脉粥样硬化的进程。因此，由于银屑病和银屑病关节炎代表心血管危险因素，初级保健医生在确定各自患者合并症的治疗目标时必须考虑到它们（例如，动脉高血压或血脂异常）。二级和三级保健医生需要考虑更全面的治疗方法，包括生活方式干预方面。最后，有效的长期抗炎、改善疾病的治疗可能有助于降低患者的心血管风险。
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.