How autoimmune conditions can be a factor for heart disease—it's not just smoking

Heart Health

by Dr. Jeffrey M. Schussler, MD, FACC, FSCAI

May 2, 2024

Most of us are aware that smoking is bad for your heart. Along with diabetes, obesity and high blood pressure (hypertension), it’s one of the highest risk behaviors that can cause heart disease, heart attacks and strokes.

Your doctor may have talked to you about changes in your lifestyle, or adding medications that help with one or more of these issues.

It’s become clearer that there are more risk factors out there that are associated with heart disease than previously thought. These “non-traditional” risk factors tend to be conditions which increase inflammation in the body.

The relationship between psoriasis and heart disease

Psoriasis is a chronic inflammatory disease affecting 125 million people worldwide, and 7 million in the United States. It’s typically thought to just affect the skin, as it shows up as a noticeable rash. What doctors are realizing now is that this condition is more than skin deep. The inflammation that is seen on the skin is the tip of the iceberg and the process affects many organs in the body, including the heart.

We were part of a study several years ago which used cardiac computed tomography (CT) scans to look at the hearts of people with psoriasis. What we found was that the amount of coronary disease seen was similar to the amount seen in people with diabetes.

It’s now recognized that psoriasis, a “skin” disease, is a risk factor for coronary disease. People who have this condition should be screened for coronary disease and treated accordingly to reduce their risk.

Other conditions that cause systemic inflammation are also now recognized as additional risk factors for heart disease. These include rheumatoid arthritis (RA), systemic lupus erythematosus (SLE) and chronic human immunodeficiency virus (HIV) infection.

Treating inflammation and your heart health

While this should not be cause for alarm, if you are living with a condition that causes systemic inflammation, it’s important to treat that process. We use the term “process” as inflammation is not just a single event but rather a series of bodily responses.

Your healthcare team will also look if this inflammation has caused plaque to start building up in your heart. There are simple ways to identify this using CT scans. These are non-invasive tests that use X-rays to scan the heart for early plaque, and are very accurate in detecting this early heart disease.

The good news is that once it’s known that a person is at risk, steps can be taken to reduce the chances of having a future heart attack. It’s been shown that effective treatment of someone’s psoriasis improves their heart artery plaques as well.

If you do have one of these non-traditional risk factors, it’s important to discuss the potential for heart disease with your doctor. It may be helpful to better define your risk for heart disease, or even start treatment specifically designed to combat heart disease.

How’s your heart? Take the heart health assessment quiz to understand your heart risks.

This image is a CT scan of a person’s heart with non-traditional risk factors. The highlighted areas of plaque in the heart arteries including the left anterior descending artery (pink), left circumflex artery (blue) and right coronary artery (green).

 

About the Author

Dr. Schussler is a general and interventional cardiologist on the medical staff at Baylor Scott & White Heart and Vascular Hospital – Dallas and Baylor University Medical Center. His interests include preventative cardiology, coronary stents, trans-radial (through the wrist) coronary intervention. More recently, his research has focused on non-invasive coronary imaging using CT scans, as well as robotic-assisted angioplasty. He is active on Twitter @Updock typically posting on new technologies and techniques in cardiology.

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