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- Presentation
Managing Cardiovascular Risk in Psoriasis Patients: A Caution Against Overstepping Dermatology's Role
Description
The speaker argues that while psoriasis is associated with increased cardiovascular risk and higher cardiovascular mortality, dermatologists should be cautious about taking on full cardiovascular management in a short office visit. He explains that evaluating lipids, calculating risk, prescribing statins, and monitoring for side effects require more time, expertise, and shared decision-making than typical dermatology appointments allow, and that attempting it poorly could cause harm or delay appropriate primary care or cardiology follow-up. Psoriasis is presented as a risk-enhancing factor, so patients with at least intermediate risk should be counseled to seek cardiovascular assessment, and dermatologists should monitor only for side effects caused by treatments they prescribe, such as retinoids or JAK inhibitors. His overall message is that dermatology should recognize the risk, coordinate care, and focus on treating the psoriasis well rather than independently managing the entire cardiovascular risk profile.
View moreConclusions
- Psoriasis, especially when extensive, is associated with increased cardiovascular risk and mortality, but that does not mean dermatologists should independently manage the full cardiovascular risk profile.
- Statins and lipid management are important for prevention, yet they require comprehensive risk assessment, monitoring, and shared decision-making that usually exceed the time and scope of a typical dermatology visit.
- Psoriasis should be treated as a cardiovascular risk-enhancing factor, particularly in patients who are already at least intermediate risk, rather than as a reason for isolated, partial risk treatment.
- Dermatologists should counsel patients about their elevated risk and refer them to primary care or cardiology for formal cardiovascular risk management instead of attempting to act as the sole risk manager.
- The most practical way dermatologists can improve cardiovascular outcomes in psoriasis patients is by effectively treating the psoriasis itself while avoiding harm from overstepping into complex cardiovascular care.
- Gelfand JM, et al. JAMA. 2006
- Noe M. et al., AAD 2017
- Arnett DK. Circulation. 2019
- Grundy SM. Circulation. 2019
- Padua Borges R. Arch Endo Metabolism. 2020
- Cholesterol Treatment Collaboration. Lancet. 2026
- Recommendations NHS, UK. 2024