Psoriasis is a chronic inflammatory skin disease that can cause significant deterioration in the quality of life of those who suffer. For some time the epidemiological association of psoriasis, especially in its severe forms, with an increased risk of coronary heart disease and cardiovascular disease occlusive known.
In patients with severe psoriasis increased prevalence of obesity, dyslipidemia, diabetes mellitus, hypertension, alcoholism, hepatic steatosis and smoking, factors that contribute significantly to increased risk of mortality in these patients, mainly related is also seen arteriosclerosis.
Metabolic syndrome is a constellation of interrelated clinical and biochemical abnormalities that include abdominal obesity, atherogenic dyslipidemia, elevated blood pressure, insulin resistance, and a proinflammatory and prothrombotic state as a risk factor for cardiovascular disease. There is no internationally agreed definition, although the proposal by the NCEP ATP-III (2001), subsequently updated by the American Heart Association (2005), it is the most used.
The fact met diagnostic criteria for metabolic syndrome, confers a relative risk of 3.65 of developing coronary heart disease, so that up to 80% of patients with metabolic syndrome die of cardiovascular complications. It is also associated with an overall increase in mortality from any cause.
To set the intensity of the intervention to be performed and therapeutic resources to use, calculating cardiovascular risk is proposed by the REGICOR tables, a calibration table original Framingham, validated in the Spanish population, in the context of limitations of all risk tables (not to be used as a definitive tool or automatic decision for prescription drugs).
Keep in mind that the dermatologist is often the only health reference for patients with psoriasis, and that more than 40% meets criteria for metabolic syndrome (without most are aware of this), and morbidity and mortality involved, it makes the specialist plays a key role in identifying these patients, in order to recommend changes in lifestyle (snuff, sedentary lifestyle, etc.) and referral to your family doctor to consider individually cases that require pharmacological intervention.
This tool allows on the one hand, establishing the diagnosis of metabolic syndrome and obesity, and secondly, the estimation of cardiovascular risk using the REGICOR tables, with recommendations to be followed in each case.