Does long-standing psoriasis affect cardiac health?

Question

Hello doctor,

I am writing about my grandmother's complicated health scenario. She is 68 and has long-standing psoriasis, but recently, her cardiologist discovered she has developed metabolic syndrome. The skin patches have become more extensive, and her recent blood work shows elevated inflammation markers. She is struggling with weight management, and the medications for her heart condition seem to be interacting with her psoriasis treatments. Her endocrinologist is concerned about insulin resistance, and we are worried about how all these conditions are interconnected. She has always been active, but now she is finding it hard to maintain her previous lifestyle. We need guidance on managing these overlapping health challenges and finding a comprehensive treatment approach.

Kindly help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

Managing your grandmother's overlapping conditions requires a multidisciplinary approach. Here are some strategies to consider:

Collaborative care team- Ensure her cardiologist, dermatologist, and endocrinologist communicate regularly to align treatment goals and minimize medication interactions.

Psoriasis management-

Biologics or systemic therapies: Consider biologic drugs like IL (interlukin)-17 or IL (interlukin)-23 inhibitors, which may also reduce inflammation contributing to metabolic syndrome.
Topical treatments: Use non-steroidal creams to minimize systemic absorption and potential interactions with other medications.

Metabolic syndrome and insulin resistance-

Dietary changes: A Mediterranean or anti-inflammatory diet can help manage both psoriasis and metabolic syndrome. Focus on whole grains, lean proteins, healthy fats, and antioxidant-rich foods.
Weight management: Engage a dietitian to create a sustainable plan that incorporates low glycemic index foods to help with insulin sensitivity.
Exercise: Gentle, low-impact activities (like yoga or swimming) can improve cardiovascular health and reduce psoriasis flare-ups.

Medication adjustments- Review her current medications to identify potential interactions. For example:

Beta-blockers (used for heart conditions) can sometimes worsen psoriasis.
Adjusting treatments with her cardiologist and dermatologist might help.

Inflammation reduction-

Monitor her inflammation markers (e.g., CRP - C-reactive protein, ESR- erythrocyte sedimentation rate) to assess treatment effectiveness.
Consider supplements like omega-3 fatty acids, vitamin D, and probiotics which can reduce systemic inflammation.

Mental and emotional health- Psoriasis and metabolic syndrome can affect self-esteem and mood. Encourage stress management techniques such as mindfulness or counseling.

Regular monitoring- Frequent check-ups to track her heart health, blood glucose levels, and psoriasis severity will help adjust treatments as needed.

Would you like a detailed plan or recommendations for specific medications, dietary tips, or therapies?

I hope this helps.

Kindly follow up if you have more concerns.

Thank you.