Association between Psoriasis Area and Severity Index Score and atherosclerotic risk in psoriasis patients using the Hisayama Score: a single-center retrospective study

Psoriasis is a chronic immune-mediated skin disorder causing systemic inflammation, which significantly increases the risk of cardiovascular disease (CVD). In Japan, the Hisayama Score was recently introduced as a comprehensive tool to assess coronary artery disease and stroke risk. This retrospective study represents the first investigation applying the Hisayama Score to psoriasis patients to determine the association between the Psoriasis Area and Severity Index (PASI) and cardiovascular risk. We analyzed data from 119 patients aged 40-79 visiting Tohoku University Hospital between 2010 and 2022. After excluding 48 patients with pre-existing comorbidities like diabetes and chronic kidney disease, 71 participants remained. Patients were stratified into low, moderate, and high-risk groups based on blood pressure, lipid profiles, and smoking history. Results showed that higher PASI scores were significantly associated with increased cardiovascular risk (<i>p</i> = 0.003). Notably, male patients with PASI scores exceeding 10 were frequently categorized into moderate or high-risk groups (<i>p</i> = 0.049). Additionally, systolic blood pressure was identified as an independent predictor. These findings suggest that psoriasis severity correlates with elevated cardiovascular risk, validating the Hisayama Score's utility in this population and highlighting the critical need for dermatologists to implement proactive, interdisciplinary risk management strategies.