Blood Pressure And Heart Complications
High blood pressure or hypertension is also common in people living with lupus. In fact, 50 percent of people with lupus have blood pressure greater than 140/90 mmHg, and nearly 75 percent of people with lupus have blood pressure greater than what is considered normal in healthy patients, which is 120/80 mmHg.2,3
High blood pressure in people with lupus is commonly caused by obesity, kidney disease, and long-term steroid use. Some other treatments prescribed for lupus, such as cyclosporine, may also contribute to high blood pressure.2
Which Psoriasis Medications May Have Heart
The psoriasis medications that may reduce the risk of heart and blood vessel diseases are prescribed to treat moderate or severe psoriasis. These medications include:
These are potent medications that have possible side effects. For this reason, a dermatologist screens each patient carefully before prescribing one of these medications. Even if you have an increased risk of heart or blood vessel disease, one of these medications may not be suitable for you.
Research And Statistics: Who Has Psoriatic Arthritis
Psoriatic arthritis affects about 1.5 million people in the United States.
According to the Arthritis Foundation, about 30 percent of individuals with psoriasis develop psoriatic arthritis.
The condition usually affects those between ages 30 and 50, but it can start at any age, even in childhood. Men and women are equally at risk for having psoriatic arthritis.
Most people develop psoriasis first and then are diagnosed with psoriatic arthritis about 10 to 20 years later.
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Sex Fertility And Pregnancy
Sex can sometimes be painful for people with psoriatic arthritis, particularly a woman whose hips are affected. Experimenting with different positions and communicating well with your partner will usually provide a solution.
Psoriatic arthritis wont affect your chances of having children. But if youre thinking of starting a family, its important to discuss your drug treatment with a doctor well in advance. If you become pregnant unexpectedly, talk to your rheumatology department as soon as possible.
The following must be avoided when trying to start a family, during pregnancy and when breastfeeding:
Review Medications With A Doctor
Some medications for PsA may reduce the risk of heart disease, while others may increase it.
For example, steroids can raise cholesterol levels and cause the body to become less sensitive to insulin. In turn, this can contribute to the risk of cardiovascular disease.
Conversely, biologics and disease-modifying antirheumatic drugs can not only ease pain in the joints but also protect the heart.
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Types Of Psoriatic Arthritis
Here are the five different types of psoriatic arthritis:
- Symmetric psoriatic arthritis As its name implies, this type affects joints on both sides of your body at the same time. About half of people with psoriatic arthritis have the symmetric kind.
- Asymmetric psoriatic arthritis With the asymmetric type, problems dont develop in the same joints on both sides of the body. It occurs in about 35 percent of people with the disease and often causes more mild symptoms.
- Spondylitis This form of psoriatic arthritis is characterized by pain and stiffness in the neck and spine.
- Arthritis mutilans People with arthritis mutilans experience deformities in the small joints at the ends of the fingers and toes. This type is considered the most severe form of psoriatic arthritis, but it only affects about 5 percent of people with the condition.
- Distal psoriatic arthritis It causes inflammation and stiffness near the ends of the fingers and toes, while also affecting the nails.
Chronic Obstructive Pulmonary Disease
This association is greater in those with severe psoriasis or psoriatic arthritis. Smoking with either of these conditions can make the risk even greater.
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Key Points About Psoriatic Arthritis
- Psoriatic arthritis is a form of arthritis with a skin rash.
- Psoriasis is a chronic skin and nail disease. It causes red, scaly rashes and thick, pitted fingernails. The rash may come before or after the arthritis symptoms.
- Psoriatic arthritis causes inflamed, swollen, and painful joints. It happens most often in the fingers and toes. It can lead to deformed joints.
- Treatment may include medicines, heat and cold, splints, exercise, physical therapy, and surgery.
Can Psoriatic Arthritis Affect Other Parts Of The Body
Having psoriatic arthritis can put you at risk of developing other conditions and complications around the body.
The chances of getting one of these are rare. But its worth knowing about them and talking to your doctor if you have any concerns.
Seek urgent medical attention if one or both of your eyes are red and painful, particularly if you have a change in your vision. You could go to your GP, an eye hospital, or your local A& E department.
These symptoms could be caused by a condition called uveitis, which is also known as iritis. It involves inflammation at the front of the eye.
This can permanently damage your eyesight if left untreated.
Other symptoms are:
- blurred or cloudy vision
- sensitivity to light
- not being able to see things at the side of your field of vision known as a loss of peripheral vision
- small shapes moving across your field of vision.
These symptoms can come on suddenly, or gradually over a few days. It can affect one or both eyes. It can be treated effectively with steroids.
Psoriatic arthritis can put you at a slightly higher risk of having a heart condition. You can reduce your risk by:
- not smoking
- staying at a healthy weight
- exercising regularly
- eating a healthy diet, thats low in fat, sugar and salt
- not drinking too much alcohol.
These positive lifestyle choices can help to improve your arthritis and skin symptoms.
Talk to your doctor if you have any concerns about your heart health.
Non-alcoholic fatty liver disease
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How Will Psoriatic Arthritis Affect Me
Starting the right treatment as soon as possible will give you the best chance of keeping your arthritis under control and minimise damage to your body.
Psoriatic arthritis can vary a great deal between different people. This makes it difficult to offer advice on what you should expect.
It will usually have some effect on your ability to get around and your quality of life, but treatment will reduce the effect it has.
Psoriatic arthritis can cause long-term damage to joints, bones and other tissues in the body, especially if it isnt treated.
What Is Psoriatic Arthritis Symptoms Causes Diagnosis Treatment And Prevention
Psoriatic arthritis is a type of inflammatory arthritis that affects some people with psoriasis a condition that causes the rapid buildup of skin cells.
Its considered an autoimmune disease which means your bodys immune system mistakenly attacks healthy tissue.
People with psoriatic arthritis experience both skin and joint problems. Symptoms may vary, depending on the case.
Usually, skin issues develop first, and the arthritis comes later. But joint problems can occasionally crop up without signs of psoriasis.
Theres no cure for psoriatic arthritis, but there are plenty of therapies to help lessen the discomfort and joint damage.
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Past Research And Achievements In This Area
In 2015, research led by our centre for genetics and genomics at the University of Manchester identified genetic variants associated with psoriatic arthritis, but not with psoriasis or rheumatoid arthritis. This helped to establish psoriatic arthritis as a condition in its own right. The findings could lead to the development of drugs specifically for psoriatic arthritis.
Later in the same year, our TICOPA trial looked at the benefits of early aggressive drug treatment for people with psoriatic arthritis followed by an increase in drug dosage if initial treatment isnt working. The trial found that patients treated this way, required fewer hospital- and community-based services than patients receiving the standard care.
What You Can Do
You can do a lot to reduce your risk of heart disease. Heres how:
- If you smoke, stop. In addition to promoting inflammation, smoking likely reduces treatment response in patients with PsA, according to Dafna Gladman, MD, a professor of rheumatology at the University of Toronto in Canada.
- Get moving. Staying active improves pain and function and cuts the risk of heart disease nearly in half.
- Eat well. A heart-healthy diet helps control weight, blood sugar and cholesterol and can reduce inflammation.
- Watch your medications. Work with your doctor to find medications that control pain and inflammation without raising heart disease risk.
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Can Psoriatic Arthritis Affect The Esophagus
Psoriatic arthritis is an autoimmune condition that affects many parts of the body, such as the eyes and gastrointestinal tract, including the esophagus. Symptoms of PsA may include inflamed, itchy skin, swollen joints, and the possibility of infections.
The inability to swallow effectively is known as dysphagia. Studies have not yet found a clear link between PsA and dysphagia, but research is ongoing.
This article examines whether PsA affects the esophagus. It also explores potential esophageal-related problems PsA may cause and possible treatment options.
People who have dysphagia may experience symptoms such as:
- difficulty swallowing starchy foods, such as bread or potatoes
- feeling as though food is too big to swallow
- pain in the chest when food travels down the esophagus
- acid reflux after a meal or after eating particular foods
- gastroparesis, where the stomach muscles that push food through the intestines stop working or slow down
- weakness in the esophagus that can cause a pocket to form and trap food
- inflammatory bowel syndrome that has links to PsA through triggering chronic inflammation
- ulcerative colitis that relates to PsA and may cause mouth ulcers
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- foreign bodies or food lodged in the throat
- throat infection
- peptic ulcer disease
- some medications for PsA, including methotrexate, adalimumab, infliximab, and leflunomide, may cause difficulty swallowing as a side effect
- Sjögrens disease
- stroke or head injury
About 30% Of People Who Have Psoriasis Also Develop A Form Of Arthritis Called Psoriatic Arthritis
Unlike other forms of arthritis, men and women are at equal risk for developing this condition. It causes joint pain and swelling that can lead to joint damage if not controlled over time. Most people with PsA have skin symptoms before joint symptoms. However, some people get PsA without any changes to the skin, and some people develop rashes after the arthritis. Severe skin psoriasis does not necessarily indicate a stronger possibility of developing arthritis.
PsA occurs when the bodys immune system mistakenly attacks joints and skin. This triggers joint pain, stiffness and swelling. The disease can lay dormant in the body until it is triggered by an outside influence, such an infection. The inflammation from PsA can affect the entire body and may lead to permanent joint and tissue damage if it is not treated early and aggressively. PsA can affect any joint. It can also cause tenderness where tendons and ligaments join the bones. This condition, called enthesitis, can result in pain at the back of the heel, the sole of the foot, around the elbows or in other areas. Enthesitis is one of the characteristic features of PsA.
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Does Treating/controlling Psa Reduce Heart Disease Risk
It makes sense that treating your psoriatic arthritis to keep heart-damaging inflammation at bay would reduce heart disease risk, although researchers are continuing to study this very question.
One observational study published this year in the journal Cardiovascular Research looked at 215 psoriasis patients with low cardiovascular risk. Some were on a biologic, while others opted not to be. After a year of follow-up, those who were on biologic treatment were found to have a 6 percent reduction in arterial plaque, likely because of a reduction in underlying inflammation.
We do think treating a psoriatic condition will reduce the risk of heart disease, but we dont know that yet, says Dr. Garshick. However, there are multiple other reasons to treat your PsA.
That said, just because your PsA may be well controlled say, in terms of minimal flares does not mean you can assume everything is fine regarding your heart health. You still should be assessed for additional heart disease risk factors and practice healthy preventive lifestyle habits, he says.
If You Notice Symptoms Suggestive Of A Heart Attack Or Stroke Seek Emergency Medical Attention Immediately
- Take action! Do not smoke. If you are a smoker, take steps to reduce the amount you smoke.
- Maintain a healthy weight. If your waist measures more than 102 centimetres for men or 88 centimetres for women, talk to your GP about weight loss strategies.
- Eat a balanced diet, including whole grains, cereals, vegetables, fruit, lower-fat dairy products, leaner meats and food prepared with little to no fat. Avoid saturated and trans-fats instead use olive oil, which is high in desirable monounsaturated fats.
- Control your portion sizes. An easy method for determining meal portions is to use two open hands as your measure for vegetables one closed hand for carbohydrates, such as pasta or rice one closed hand for fruit the palm of your hand for meat or protein alternative and the tip of your thumb for fats, such as oil, margarine or butter.
- Limit alcohol intake.
- Deal with stress in a healthy way.
- Be physically active for at least 30 minutes most days of the week.
Drink more water. Although there is no strict guideline, replacing fluids is important and you should aim to drink at least 2-3 litres of water a day, particularly during warm or hot weather.
This article is adapted from the Psoriasis and the heart leaflet.
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What Is Psoriatic Arthritis
Psoriatic arthritis is a type of arthritis linked with psoriasis, a chronic skin andnail disease. Psoriasis causes red, scaly rashes and thick, pitted fingernails.Psoriatic arthritis is similar to rheumatoid arthritis in symptoms and jointswelling . But it tends to affect fewer joints than RA. And it does notmake the typical RA antibodies. The arthritis of psoriatic arthritis comes in 5forms:
- Arthritis that affects the small joints in the fingers, toes, or both
- Asymmetrical arthritis of the joints in the hands and feet
- Symmetrical polyarthritis, which is similar to RA
- Arthritis mutilans, a rare type of arthritis that destroys and deforms joints
- Psoriatic spondylitis, arthritis of the lower back and the spine
Psoriasis and Psoriasis Arthritis FAQ
What You Can Change
- Men and women should not drink more than 14 units a week on a regular basis
- Spread your drinking over 3 or more days if you regularly drink 14 units a week
- If you want to cut down, try to have several drink-free days each week
14 units is equivalent to 6 pints of average-strength beer or 10 small glasses of low-strength wine.
The following table will show you how many units are in different alcoholic drinks.
Type of drink
Large glass of red/white/rosé wine
Remember: for certain medications you will be advised to avoid alcohol , so do make sure your healthcare provider is aware of your alcohol consumption.Stress: Stress can increase your risk of heart disease, and it may also encourage your psoriasis to flare. It is important to learn how to reduce your stress in a healthy way rather than resorting to unhealthy strategies such as smoking, drinking and overeating. Exercise, yoga and relaxation techniques can be effective. Healthy stress release, such as listening to music, meeting with friends or pursuing a hobby is really good too. You may also wish to talk to your doctor about counselling or medication.
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Symptoms Of Psoriatic Arthritis
The severity of the condition can vary considerably from person to person. Some people may have severe problems affecting many joints, whereas others may only notice mild symptoms in 1 or 2 joints.
There may be times when your symptoms improve and periods when they get worse .
Relapses can be very difficult to predict, but can often be managed with medicine when they do occur.
Screening For Heart Disease In Psoriatic Arthritis
Sometimes there is just so much to talk about at your visit with your rheumatologist or dermatologist that discussing the possibility of future heart disease risk may not take top priority. Still, when it comes to prevention, one of the most important things you can do is have this conversation with your doctor and ask about the steps you can take to improve your heart health.
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Helpful Tips To Prevent Psoriasis
Triggers for psoriasis include stress, anxiety, infections, hormonal changes or even injuries to the skin. Some medications such as lithium and beta blockers can also trigger a psoriasis flare-up. In some cases, genetics are thought to play a role, as individuals with a parent who has psoriasis are 15% more likely to develop the disease.
Though there is evidence that psoriasis and hypertension are linked to comorbid conditions, it is still unknown if controlling the symptoms of psoriasis also will improve your overall cardiovascular health.
However, many of the same lifestyle choices you can make to reduce the risk of high blood pressure not smoking, eating a healthier diet, maintaining healthy body weight, regular exercise and limiting alcohol intake can also be good for your psoriasis.
Obesity can make psoriasis symptoms worse. Reducing your stress and eating a healthy diet will help reduce inflammation in the body, which will ultimately lead to fewer flare-ups and improve your chances of avoiding cardiovascular disease.
If you have moderate to severe psoriasis, always let your primary care doctor know, as you may be at risk for hypertension and other chronic conditions. Monitor your cardiac risk factors such as blood pressure, cholesterol, and inflammation and see your dermatologist to maintain control of your psoriasis.