Therapy of concomitant essential hypertension in patients with psoriasis: Clinical features and therapeutic approaches

Introduction. Psoriasis is a chronic immune-mediated skin disease, often accompanied by a large number of concomitant disorders, among which a special place is occupied by cardiovascular diseases. A vast number of scientific publications is devoted to the topic of psoriasis and cardiovascular comorbidities. The risk of cardiovascular dysfunction is 2 times higher in patients with psoriasis than in the population in general, just like the incidence of cardiac pathologies. European clinical guidelines urge to carry out cardiac screening in this group of patients to ensure timely prescription of appropriate therapy. Aim. To study the effect of antihypertensive therapy on the course of psoriasis in patients with concomitant essential hypertension. Materials and methods. We analysed medical records of 120 patients with psoriasis. They were divided into 2 groups. The first group had concomitant hypertension and the second group did not. Data from the medical records, physical examinations, consultations with GPs and cardiologists were reviewed. Results. Our retrospective chart review of 120 patients with psoriasis showed that physicians most often prescribe to patients with essential hypertension (EH) the drugs that can provoke exacerbations of psoriasis. Also, patients with EH had more pronounced clinical manifestations of psoriasis, which could be explained by the impact of the cardiopathology itself and its drug therapy. Conclusions. Given the features of comorbid disorders in psoriasis, the close collaboration of dermatologists and cardiologists is needed. In patients with psoriasis, routine cardiac screening, lifestyle changes and other measures aimed at reducing the risk of cardiovascular diseases are indicated. In the group of patients with concomitant essential hypertension, antihypertensive drugs with a relatively more favourable safety profile should be prescribed, for example calcium channel blockers, angiotensin II receptor blockers, imidazoline receptor agonists and diuretics.