银屑病患者如何管理心血管疾病:临床证据与时间管理。

Maria-Angeliki Gkini,Pamela Diaz,Cheryl F Rosen,Claudia Goldenstein-Schainberg
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摘要

银屑病(PsD)患者的心血管(CV)疾病(CVD)的早期识别和适当管理是预防早期发病和死亡的关键。PsD与CVD具有共同的致病机制,包括肿瘤坏死因子等促炎细胞因子的上调。所有PsD患者应通过临床病史、危险因素评估(如糖尿病、高血压、血脂异常)、血液检查和影像学检查来评估潜在的CV合并症。与病人的初级保健医生合作是必不可少的,提供预防措施,如健康的生活方式建议(例如,饮食、运动、减肥、戒烟和戒酒)。合并症的管理需要家庭医生、内科医生、心脏病专家、皮肤科医生和风湿病专家的多学科合作。建议治疗银屑病关节炎和银屑病以缓解;然而,关于心血管疾病风险改变的数据仍然不确定,需要进一步的研究。因此,尽管临床时间限制和缺乏支持人员等实际困难,仍应向PsD患者提供常规CVD评估和管理。在银屑病和银屑病关节炎研究和评估小组(GRAPPA) 2024年年会上,皮肤病学家和风湿病学家在临床评估和管理CVD的证据和经验被提出。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
How to Manage Cardiovascular Disease in Psoriatic Disease: Evidence and Time Management in Clinic.
Early recognition and appropriate management of cardiovascular (CV) disease (CVD) in patients with psoriatic disease (PsD) is critical for prevention of early morbidity and mortality. PsD and CVD share common pathogenic mechanisms, including upregulation of proinflammatory cytokines like tumor necrosis factor. Potential CV comorbidities should be assessed in all patients with PsD through clinical history, risk factor assessment (eg, diabetes, hypertension, dyslipidemia), blood tests, and imaging, when required. Collaboration with the patient's primary care physician is essential, offering preventive measures such as healthy lifestyle advice (eg, diet, exercise, weight loss, smoking and drinking cessation). Management of comorbid conditions requires a multidisciplinary setting of family doctors, internists, cardiologists, dermatologists, and rheumatologists. Treating psoriatic arthritis and psoriasis to remission is recommended; however, the data on CVD risk modification remain inconclusive, necessitating further studies. Thus, routine CVD assessment and management should be provided to patients with PsD, despite practical difficulties such as clinical time constraints and lack of support staff. The evidence and experiences of a dermatologist and rheumatologist assessing and managing CVD in clinic were presented at the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) 2024 annual meeting.
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