Editing Psoriasis (section)

===Cardiovascular disease===
Psoriasis has been associated with [[obesity]]<ref name=Menter2008 /> and several other cardiovascular and metabolic disturbances. The [[Incidence (epidemiology)|number of new cases per year]] of diabetes is 27% higher in people affected by psoriasis than in those without the condition.<ref name=Sh2014>{{cite journal | vauthors = Shlyankevich J, Mehta NN, Krueger JG, Strober B, Gudjonsson JE, Qureshi AA, Tebbey PW, Kimball AB | title = Accumulating evidence for the association and shared pathogenic mechanisms between psoriasis and cardiovascular-related comorbidities | journal = The American Journal of Medicine | volume = 127 | issue = 12 | pages = 1148–53 | date = December 2014 | pmid = 25149424 | pmc = 4259841 | doi = 10.1016/j.amjmed.2014.08.008 }}</ref> Severe psoriasis may be even more strongly associated with the development of diabetes than mild psoriasis.<ref name=Sh2014/> Younger people with psoriasis may also be at increased risk for developing diabetes.<ref name=Habif2010 /> Individuals with psoriasis or psoriatic arthritis have a slightly higher risk of heart disease and [[Myocardial infarction|heart attacks]] when compared to the general population. Cardiovascular disease risk appeared to be correlated with the severity of psoriasis and its duration. There is no strong evidence to suggest that psoriasis is associated with an increased risk of death from cardiovascular events. [[Methotrexate]] may provide a degree of protection for the heart.<ref name="Richard2013">{{cite journal | vauthors = Richard MA, Barnetche T, Horreau C, Brenaut E, Pouplard C, Aractingi S, Aubin F, Cribier B, Joly P, Jullien D, Le Maître M, Misery L, Ortonne JP, Paul C | title = Psoriasis, cardiovascular events, cancer risk and alcohol use: evidence-based recommendations based on systematic review and expert opinion | journal = Journal of the European Academy of Dermatology and Venereology | volume = 27 | issue = Supplement 3 | pages = 2–11 | date = August 2013 | pmid = 23845148 | doi = 10.1111/jdv.12162 | s2cid = 2766931 | doi-access = free }}</ref><ref name=Habif2010 />

The odds of having [[hypertension]] are 1.58 times {{nowrap|( ''i.e.'' 58%)}} higher in people with psoriasis than those without the condition; these odds are even higher with severe cases of psoriasis. A similar association was noted in people who have psoriatic arthritis—the odds of having hypertension were found to be 2.07 times {{nowrap|( ''i.e.'' 107%)}} greater when compared to odds of the general population. The link between psoriasis and hypertension is not currently{{when|date=October 2019}} understood. Mechanisms hypothesized to be involved in this relationship include the following: dysregulation of the [[renin–angiotensin system]], elevated levels of [[endothelin 1]] in the blood, and increased [[oxidative stress]]. The number of new cases of the heart rhythm abnormality [[atrial fibrillation]] is 1.31 times {{nowrap|( ''i.e.'' 31%)}} higher in people with mild psoriasis and 1.63 times {{nowrap|( ''i.e.'' 63%)}} higher in people with severe psoriasis.<ref name="Tablazon2013"/> There may be a slightly increased risk of [[stroke]] associated with psoriasis, especially in severe cases.<ref name="Richard2013"/><ref>{{cite news|title=Psoriasis Linked to Stroke Risk|publisher=BBC|url=https://www.bbc.co.uk/news/health-14559523|date=August 2011|url-status=live|archive-url=https://web.archive.org/web/20110828171242/http://www.bbc.co.uk/news/health-14559523|archive-date=28 August 2011}}</ref> Treating [[hypercholesterolemia|high levels of cholesterol]] with [[statin]]s has been associated with decreased psoriasis severity, as measured by PASI score, and has also been associated with improvements in other cardiovascular disease risk factors such as markers of [[inflammation]].<ref name="Ghazizadeh2011">{{cite journal | vauthors = Ghazizadeh R, Tosa M, Ghazizadeh M | title = Clinical improvement in psoriasis with treatment of associated hyperlipidemia | journal = The American Journal of the Medical Sciences | volume = 341 | issue = 5 | pages = 394–8 | date = May 2011 | pmid = 21233693 | doi = 10.1097/MAJ.0b013e3181ff8eeb | s2cid = 12519829 }}</ref> These [[Cardioprotection|cardioprotective]] effects are attributed to ability of statins to improve blood [[lipid]] profile and because of their anti-inflammatory effects. Statin use in those with psoriasis and [[hyperlipidemia]] was associated with decreased levels of [[high-sensitivity C-reactive protein]] and [[TNFα]] as well as decreased activity of the immune protein [[Lymphocyte function-associated antigen 1|LFA-1]].<ref name="Ghazizadeh2011"/> Compared to individuals without psoriasis, those affected by psoriasis are more likely to satisfy the criteria for [[metabolic syndrome]].<ref name="Raychaudhuri2014">{{cite journal | vauthors = Raychaudhuri SK, Maverakis E, Raychaudhuri SP | title = Diagnosis and classification of psoriasis | journal = Autoimmunity Reviews | volume = 13 | issue = 4–5 | pages = 490–5 | date = January 2014 | pmid = 24434359 | doi = 10.1016/j.autrev.2014.01.008 }}</ref><ref name="Tablazon2013">{{cite journal | vauthors = Tablazon IL, Al-Dabagh A, Davis SA, Feldman SR | title = Risk of cardiovascular disorders in psoriasis patients: current and future | journal = American Journal of Clinical Dermatology | volume = 14 | issue = 1 | pages = 1–7 | date = February 2013 | pmid = 23329076 | doi = 10.1007/s40257-012-0005-5 | s2cid = 207482092 }}</ref>