Cardiovascular risks in patients with severe psoriasis depending on the psoriatic arthritis presence

Abstract

Background: patients with psoriasis (Ps) and psoriatic arthritis (PsA) have a higher risk of cardiovascular disease (CVD) than the general population. However, most studies either consider patients with Ps as a single nosological group or focus exclusively on patients with PsA. Therefore, a comparative analysis of the structure and frequency of cardiovascular comorbidities, as well as factors increasing the likelihood of life-threatening CVD, separately in patients with cutaneous manifestations of Ps alone and in patients with PsA, remains a relevant clinical issue. Aim: to perform a comparative analysis of the frequency and structure of cardiovascular risk factors in patients with Ps depending on the presence or absence of PsA. Materials and Methods: this multicenter retrospective study included 972 patients diagnosed with moderate-to-severe and severe psoriasis between 2016 and 2025. We compared the presence of CVD in patients with Ps with and without PsA, as well as cardiovascular risk factors, including smoking, elevated blood pressure, diabetes mellitus, dyslipidemia, and obesity. Results: analysis and comparison of cardiovascular comorbidities in patients with Ps without PsA and in those with PsA revealed a significantly higher prevalence of CVD among patients with PsA. CVD was diagnosed in 79.6% of patients with Ps and PsA and in 52.8% of patients without PsA (χ2=64.49, p<0.00001). Arterial hypertension of varying severity was diagnosed in 64.8% of patients with Ps and PsA and in 47.4% of patients without PsA (χ2=25.84, p<0.00001); coronary artery disease and atherosclerosis were detected in 40.6% and 31.2% of patients, respectively (χ2=8.41, p=0.0037); cerebrovascular disease in 12.6% and 6.7%, respectively (χ2=9.35, p=0.0022); and obesity in 18.9% and 11.3%, respectively (χ2=8.43, p=0.0037). Smoking was reported by 43.5% of patients in the overall study cohort, including 46.9% of patients without PsA and 36.9% of patients with PsA (χ2=7.7805, p<0.00528). In patients with Ps and PsA, total cholesterol levels were significantly higher than in patients without PsA: 5.25±1.184 mmol/L and 5.06±1.153 mmol/L, respectively (p=0.037). Triglyceride levels did not differ significantly between the groups and were 1.63±0.92 mmol/L in the group without PsA and 1.74±1.04 mmol/L in the group with PsA (p=0.627). LDL cholesterol levels were significantly higher in patients with PsA than in those without PsA: 2.925±0.703 mmol/L and 2.543±0.664 mmol/L, respectively (p=0.026). Conclusion: the presence of PsA is associated with a higher frequency of cardiovascular risk factors versus patients with Ps without PsA. These findings support the need for mandatory cardiological screening and active patient management with PsA aimed at correcting and potentially mitigating the impact of CVD risk factors. KEYWORDS: psoriasis, psoriatic arthritis, cardiovascular risks, body mass index, type 2 diabetes mellitus, dyslipidemia. FOR CITATION: Batkaeva N.V., Olisova O.Yu. Cardiovascular risks in patients with severe psoriasis depending on the psoriatic arthritis presence. Russian Medical Inquiry. 2026;10(6):344–351 (in Russ.). DOI: 10.32364/2587-6821-2026-10-6-2