Psoriatic arthritis significantly increases the risk of heart disease and stroke compared to people without the condition

People with psoriatic arthritis have a higher chance of developing heart disease, heart attack, and stroke than the general population. The increased risk comes from two sources: the chronic inflammation that psoriatic arthritis causes throughout the body, and the shared risk factors that often accompany the condition, such as high blood pressure and obesity. Research shows that people with psoriatic arthritis are roughly 1.5 to 2 times more likely to experience a cardiovascular event, though the exact increase varies based on how severe the arthritis is, how long you have had it, and what other health conditions you have.

The inflammation in psoriatic arthritis does not stay in your joints. It spreads through your bloodstream and can damage the lining of your arteries, making it easier for plaque to build up. This process, called atherosclerosis, narrows the arteries and reduces blood flow to your heart and brain. The longer the inflammation goes untreated, the greater the damage tends to be.

Key Takeaways

  • Psoriatic arthritis causes body-wide inflammation that damages artery linings and increases heart disease risk by roughly 50 to 100 percent compared to people without the condition.
  • The risk is highest in people with severe psoriatic arthritis, those who have had it for many years, and those who also have high blood pressure, high cholesterol, or obesity.
  • Controlling the inflammation in your psoriatic arthritis with medication is one of the most effective ways to lower your heart disease risk.
  • You should tell your doctor about any chest pain, shortness of breath, unusual fatigue, or pain in your arm or jaw, as these can signal heart problems in people with psoriatic arthritis.

How inflammation in psoriatic arthritis damages your heart and arteries

Psoriatic arthritis is an autoimmune condition, meaning your immune system mistakenly attacks the lining of your joints and other tissues. This triggers ongoing inflammation. Unlike inflammation from an injury, which goes away once you heal, autoimmune inflammation persists and spreads. Your bloodstream carries inflammatory chemicals throughout your body, and these chemicals can injure the inner walls of your arteries.

When artery linings are damaged, cholesterol and other substances begin to stick to the walls and form plaques. Over time, these plaques narrow the artery and harden, a process called atherosclerosis. If a plaque ruptures, a blood clot can form and block the artery completely, causing a heart attack or stroke. People with psoriatic arthritis develop atherosclerosis earlier and more aggressively than people without the condition, even when their cholesterol levels are similar.

The inflammation also affects how your arteries function. Healthy arteries expand and contract to regulate blood flow and blood pressure. Inflamed arteries lose this flexibility, which raises blood pressure and makes your heart work harder. Over years, this extra strain weakens the heart muscle itself.

Which people with psoriatic arthritis face the highest heart disease risk

Not everyone with psoriatic arthritis has the same level of heart disease risk. The risk is highest in people whose arthritis is severe or has been active for many years without good control. People who have visible skin psoriasis along with their joint disease also tend to have higher cardiovascular risk than those with arthritis alone, because skin psoriasis is a sign of more intense systemic inflammation.

Your risk also depends on other health conditions you have. If you have high blood pressure, high cholesterol, diabetes, or obesity, your heart disease risk from psoriatic arthritis is compounded. Smoking, physical inactivity, and a diet high in processed foods all add to the risk. Men with psoriatic arthritis generally face higher cardiovascular risk than women, and risk increases with age.

People who are overweight or obese face a double burden: obesity itself raises heart disease risk, and it also worsens the inflammation in psoriatic arthritis. Weight loss, even modest amounts, can reduce both the arthritis inflammation and the cardiovascular risk.

How treating psoriatic arthritis lowers heart disease risk

The most important step you can take to protect your heart is to control the inflammation in your psoriatic arthritis. When inflammation is well-controlled, the damage to your arteries slows or stops. Biologic medications and other disease-modifying drugs work by quieting the immune system and reducing inflammation throughout your body. Studies show that people who take these medications have lower rates of heart disease than people whose arthritis inflammation is not well-controlled, even if their cholesterol and blood pressure are similar.

Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen reduce pain and swelling, but they do not slow the underlying disease. Long-term NSAID use can actually raise blood pressure and increase heart disease risk in some people, so they are best used short-term and under your doctor's guidance. If you take NSAIDs regularly, your doctor should monitor your blood pressure and heart health.

Beyond medication, lifestyle changes matter. Regular physical activity—even gentle movement like walking or swimming—reduces inflammation, helps you maintain a healthy weight, and strengthens your heart. A diet rich in vegetables, fish, and whole grains and low in processed foods and sugar helps control inflammation and cholesterol. If you smoke, quitting is one of the single most powerful things you can do to lower your heart disease risk.

What heart disease screening looks like for people with psoriatic arthritis

Your doctor should assess your heart disease risk as part of your regular psoriatic arthritis care. This usually includes checking your blood pressure, cholesterol levels, and blood sugar at least once a year. Your doctor may ask about your family history of heart disease, whether you smoke, and how active you are. Based on these factors, your doctor may recommend additional screening.

Common screening tests include an electrocardiogram (EKG), which records the electrical activity of your heart and can show signs of damage or strain. A stress test, in which you exercise while your heart is monitored, can reveal whether your arteries are narrowed. Some doctors order a coronary calcium scan, a type of CT scan that measures calcium buildup in your arteries—a sign of atherosclerosis. These tests are not routine for everyone, but your doctor may recommend them if you have multiple risk factors or if you are over 50.

If you have had psoriatic arthritis for many years, have severe disease, or have other risk factors like high blood pressure or diabetes, talk with your doctor about whether heart disease screening is right for you. Catching problems early, when they are easier to treat, can prevent a heart attack or stroke.

Warning signs of heart problems in people with psoriatic arthritis

Some people with heart disease have no symptoms until they have a heart attack. Others notice warning signs that should prompt you to seek care. Chest pain or pressure, especially pain that comes on with activity and goes away with rest, is a classic sign. Shortness of breath, either during activity or at rest, can signal that your heart is not pumping blood efficiently. Unusual fatigue or weakness, especially if it is new or worsening, can also be a sign of heart trouble.

Pain or pressure in your arm, neck, jaw, or back can accompany heart problems, particularly in women. Some people feel lightheaded or dizzy. If you have any of these symptoms, do not wait—call 911 or go to an emergency room. Do not assume the symptom is caused by your arthritis. Tell the emergency room staff that you have psoriatic arthritis, because this information helps them assess your heart disease risk more accurately.

Even if a symptom goes away on its own, report it to your doctor at your next visit. Symptoms that come and go can still signal a serious problem. Your doctor may order tests to rule out heart disease or may refer you to a cardiologist for further evaluation.

Steps you can take now to protect your heart

Start by making sure your psoriatic arthritis is being treated aggressively. If you are not currently taking a biologic or disease-modifying medication, or if your current medication is not controlling your symptoms well, talk with your rheumatologist about adjusting your treatment. Controlling inflammation is the foundation of heart protection.

Work with your doctor to manage other risk factors. If you have high blood pressure, high cholesterol, or diabetes, treating these conditions is as important as treating your arthritis. Take medications as prescribed, and ask your doctor what your target blood pressure and cholesterol numbers should be. If you are overweight, even a 5 to 10 percent weight loss can make a measurable difference in both your arthritis and your heart health.

Move your body regularly. You do not need to run marathons—a 30-minute walk most days of the week is enough to reduce inflammation and strengthen your heart. If your arthritis makes exercise painful, ask your doctor or a physical therapist about activities that are safe for you. Reduce stress through activities you enjoy, limit alcohol, and avoid smoking. These changes take time to show results, but they work.

Frequently Asked Questions

Can psoriatic arthritis cause a heart attack?

Psoriatic arthritis itself does not directly cause a heart attack, but the chronic inflammation it causes increases the risk of atherosclerosis and blood clots, which can lead to a heart attack. People with psoriatic arthritis who also have high blood pressure, high cholesterol, or other risk factors face the highest risk. This is why controlling the inflammation and managing other risk factors is so important.

Does treating psoriatic arthritis with biologics protect my heart?

Yes. Biologic medications reduce the body-wide inflammation that damages arteries. Studies show that people taking biologics have lower rates of heart disease than those whose arthritis inflammation is not well-controlled. If your current treatment is not controlling your symptoms, talk with your rheumatologist about whether a different medication might work better for you.

Should I avoid exercise if I have psoriatic arthritis and heart disease risk?

No. Regular, moderate activity is one of the best things you can do for both your arthritis and your heart. Walking, swimming, and cycling are gentle on joints while strengthening your heart. Talk with your doctor about what type and amount of exercise is safe for you, especially if you have symptoms like chest pain or shortness of breath.

How often should I have my heart checked if I have psoriatic arthritis?

This depends on your individual risk factors. At minimum, your doctor should check your blood pressure and cholesterol yearly. If you have multiple risk factors—such as high blood pressure, diabetes, obesity, or a family history of heart disease—your doctor may recommend more frequent screening or additional tests like an EKG or stress test. Ask your doctor what schedule is right for you.

Can I reduce my heart disease risk if my arthritis is hard to control?

Yes, even if your arthritis inflammation is not perfectly controlled, you can still lower your heart disease risk by managing other factors. Keep your blood pressure and cholesterol in target ranges, maintain a healthy weight, exercise regularly, eat a heart-healthy diet, and do not smoke. Work closely with your rheumatologist to find the best arthritis treatment for you, because better inflammation control will further reduce your risk.