Protecting your heart when you have psoriatic arthritis

Learn how PsA affects heart health, plus ways to protect yourself from heart disease.

A woman with psoriatic arthritis and high blood pressure rests after a workout—checking her heart rate on a smartwatch.

Updated on July 16, 2024.

If you have psoriatic arthritis (PsA), you may know that it can cause stiff, swollen joints and discolored, scaly skin rashes. But other parts of your body can be affected, too, including your heart. 

PsA is linked to high cholesterol and high blood pressure, which typically don’t have symptoms you can see. PsA is also connected to obesity. All three conditions are risk factors for heart disease—and they are more common in people with PsA than people who don’t have PsA. 

Heart disease is the leading cause of death in the United States, responsible for about 1 in 5 deaths each year. It’s also a top cause of death for people with PsA.

Cholesterol levels and PsA

Not everyone with PsA has heart issues, however. And there are steps you can take to reduce your risk. These steps start with having your cholesterol levels checked by a healthcare provider (HCP). 

"Because dyslipidemia is a common issue with PsA, cholesterol is something that gets checked for many patients," says Arthur Kavanaugh, MD, professor of medicine and director of the Center for Innovative Therapy (CIT) at UC San Diego Rheumatology, Allergy & Immunology. People with PsA who may want to consider a cholesterol test are those with other risk factors for heart disease, he explains. 

Depending on your test results, your HCP may recommend medicine to help lower your cholesterol. Experts say the more severe your PsA is, the worse your cholesterol probably is.

Lifestyle changes to consider

In addition to medication, making healthy changes to your lifestyle can help lower heart disease risk. These can include the following.

Learn your numbers. When know your blood pressure and cholesterol levels and understand what they mean, you and your HCP can create a plan to manage them. 

  • Adults aged 40 and over should have blood pressure checked at least each year. Those between the ages of 18 and 39 should have it checked at least every 3 to 5 years. People with risk factors may need more frequent screenings.
  • The American Heart Association recommends that adults aged 20 and up have their cholesterol checked every four to six years. People with risk factors should be checked more frequently. 

Exercise. Even an activity as simple as walking every day can boost your heart health. That’s because exercise can increase levels of HDL (or “good”) cholesterol and lower levels of LDL (“bad”) cholesterol. It can also help lower blood pressure.

For health benefits, try to do 150 minutes of moderate-intensity activity each week, spread across a few days. Moderate activities include brisk walking, swimming, and biking. Or, you can do 75 minutes of vigorous activity weekly, like running or hiking.

Eat an overall healthy diet. Try to limit foods that contribute to inflammation. These include: 

  • Red meat
  • Processed foods like bagged snacks and other prepared goods
  • Foods high in saturated fats, like full-fat dairy products and baked goods
  • Foods and drinks with a lot of added sugars, like boxed cereal or soda

Instead, focus on getting plenty of heart-friendly fruits and veggies, fatty fish, walnuts, and products fortified with omega-3 fatty acids. The Mediterranean and DASH diets are commonly recommended by HCPs for people with PsA.

Maintain a healthy weight. Getting regular exercise and eating a heart-healthy diet can help you shed extra pounds. This can improve PsA, blood pressure, cholesterol, and heart issues.

Quit tobacco. Smoking is a risk factor for a long list of chronic illnesses, including PsA and heart disease. Kicking the habit is one of the best things you can do for your health. Talk to an HCP about quit methods that might work for you. 

Talk openly with your HCP. A rheumatologist or dermatologist may not always speak with you about your heart. So, don't be afraid to bring it up. Ask any questions that are on your mind. Sometimes, it takes a smart patient like you to get the ball rolling.

Article sources open article sources

Mayo Clinic. Psoriatic arthritis. October 2, 2021.
CreakyJoints.org. Psoriatic Arthritis and Heart Disease: What You Must Know and Do to Protect Yourself. February 3, 2020.
National Psoriasis Foundation. Related Conditions of Psoriatic Arthritis. Updated December 22, 2023.
Centers for Disease Control and Prevention. Heart Disease Facts. May 15, 2024.
Ogdie A, Maliha S, Shin D, Love TJ, et al. Cause-specific mortality in patients with psoriatic arthritis and rheumatoid arthritis. Rheumatology (Oxford). 2017 Jun 1;56(6):907-911.
Kibari, A., Cohen, A.D., Gazitt, T. et al. Cardiac and cardiovascular morbidities in patients with psoriatic arthritis: a population-based case control study. Clin Rheumatol 38, 2069–2075 (2019).
Karmacharya P, Ogdie A, Eder L. Psoriatic arthritis and the association with cardiometabolic disease: a narrative review. Ther Adv Musculoskelet Dis. 2021 Mar 2;13:1759720X21998279. 
MyPsA. Psoriatic arthritis and heart disease. Accessed July 16, 2024.
Arthritis.org. Psoriatic Arthritis and Your Heart. Reviewed February 14, 2022.
American Heart Association. Common Misconceptions About Cholesterol. Reviewed February 16, 2024.
American Heart Association. What Your Cholesterol Levels Mean. February 16, 2024.
United States Preventive Services Task Force. Hypertension in Adults: Screening. April 27, 2021.
Mayo Clinic. Blood Pressure Test. July 3, 2024.
Office of Disease Prevention and Health Promotion (OASH). Get Your Blood Pressure Checked. May 22, 2023.
American Heart Association. How to Get Your Cholesterol Tested. February 19, 2024.
American Heart Association. Prevention and Treatment of High Cholesterol (Hyperlipidemia). February 19, 2024.
Cleveland Clinic. Does Exercise Lower Cholesterol? November 3, 2021.
U.S. Department of Health and Human Services. Physical Activity Guidelines for Americans: 2nd Edition. 2018.
Caso F, Navarini L, Carubbi F, Picchianti-Diamanti A, et al. Mediterranean diet and Psoriatic Arthritis activity: a multicenter cross-sectional study. Rheumatol Int. 2020 Jun;40(6):951-958.

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