If you suffer from hypertension (high blood pressure) and use a type of medicine called a beta blocker to control it, you could be at increased risk of developing psoriasis, according to a recent study in JAMA Dermatology.
Psoriasis: An Autoimmune Condition
What is psoriasis? This skin condition, which causes raised red patches to form on knees, elbows, scalp, and/or torso, and currently affects approximately 7.5 million Americans, according to the National Psoriasis Foundation. Psoriasis occur when skin cells grow too quickly.
Psoriasis is also an autoimmune disorder—that is, a condition in which the body’s immune system mistakenly attacks healthy tissue. Autoimmune disorders can affect more than one part of the body; psoriasis, for instance, can also affect the joints (psoriatic arthritis).
More recently, researchers have recognized a relationship between psoriasis and high blood pressure. But the mechanism for this relationship is not yet completely understood, explains the JAMA Dermatology study’s lead author Abrar A. Qureshi, MD, MPH, chief of the department of dermatology at Rhode Island Hospital, and chair of dermatology at the Warren Alpert Medical School of Brown University, both in Providence.
Exploring the Connection
Qureshi and his colleagues looked at the effect of certain hypertension medications on the development of psoriasis. They combed through 12 years of data from the Nurses’ Health Study, which tracked the health of 77,728 nurses in the U.S. The nurses reported every two years on their blood pressure status and use of antihypertensive medications.
The scientists discovered that taking beta blockers for extended periods of time increases the risk of psoriasis, says Qureshi. Beta blockers, which are used to treat glaucoma and migraines as well as high blood pressure, work by inhibiting the effects of the hormone adrenaline. There was also a link between having high blood pressure for six years and an increased risk of psoriasis. What is less clear, however, is the cause and effect.
Which Comes First?
"Do individuals who are hypertensive have a certain risk for psoriasis? Or maybe people whose hypertension responds to beta blockers are at higher risk for psoriasis," Quereshi says. "We are not sure if it is the beta blockers directly that increase the risk of psoriasis or if people who have a type of hypertension that responds to beta blockers are more at risk for psoriasis."
For now, there are no specific answers but rather, recognition that more research needs to be done to understand the connection and determine exactly what it means for the general public.
For Psoriasis Patients
In the meantime, Qureshi stresses that people who have psoriasis need to understand that it’s a systemic condition that is tied to their overall health—not simply a skin ailment. And "Therefore, people with psoriasis should see their primary care physician to be checked for high blood pressure," Qureshi advises. In addition, if you have hypertension, are taking beta blockers, and are concerned about psoriasis, talk to your doctor about your risk and other hypertension treatment options.
Psoriasis patients should also know that today, treatment goes beyond addressing symptoms: "Care of the psoriasis patient has changed in the last decade. Beyond managing the skin problems, we now talk to patients seen in dermatology clinics about getting adequate exercise, eating right, and avoiding other risk factors such as smoking," he points out. To better meet patients’ needs and conform to the accountable care act, Qureshi says that many doctors, including dermatologists, consider the overall wellbeing of their patients rather than addressing specific symptoms or conditions separately. This holistic model could benefit you, so speak to your doctor.
Abrar Qureshi, MD, MPH, reviewed this article.
Sources
Qureshi, Abrar A., MD, MPH. Rhode Island Hospital, Providence, and Brigham and Women’s Hospital, Boston. Phone interview April 14, 2015.
"Facts About Psoriasis." National Psoriasis Foundation. Accessed April 22, 2015.
Wu, S., J. Han, W-Q Li, A.A. Qureshi. "Hypertension, Antihypertensive Medication Use, and Risk of Psoriasis." JAMA Dermatology 150, 9 (2014): 957-963. doi:10.1001/jamadermatol.2013.9957.
"Autoimmune Disorders." MedlinePlus. Page last updated July 16, 2013.
"Autoimmune Diseases Fact Sheet." Womenshealth.gov. Content last updated July 16, 2012.
