Physical activity is important for cardiovascular health and cardiorespiratory fitness in patients with psoriasis.

BACKGROUND: Patients with psoriasis have a level of physical activity below that recommended for cardiovascular health, which is significantly limited by disease severity and other psoriasis-specific barriers. We hypothesized that physical activity is important for cardiovascular health in patients with psoriasis and that its objective measurement could have clinical utility. AIM: To explore whether physical activity influences the risk of cardiovascular disease (CVD) in patients with psoriasis. METHODS: In total, 242 patients with chronic plaque psoriasis were recruited. History, examination and physical activity were assessed and arteriography, the noninvasive measurement of arterial function, was performed for each participant. RESULTS: We observed a significant relationship between volume of physical activity and the likelihood of future CVD as measured by pulse wave velocity (PWV; P < 0.02). We identified a significant relationship between the diastolic reflection area (DRA) and health-promoting levels of physical activity (P < 0.001), in addition to a significant correlation between DRA and the likelihood of future CVD (P < 0.001). The DRA is a complex, dimensionless variable that describes the intensity of diastolic wave reflection and the duration of diastole, which are key determinants of the blood supply to the left ventricle. Our data suggest that DRA may represent a surrogate marker for cardiorespiratory fitness. CONCLUSION: Our study describes a significant relationship between exercise, cardiorespiratory fitness and PWV, a preclinical indicator of future CVD risk, in patients with psoriasis. The DRA offers a noninvasive, objective measurement of exercise adherence, which could have clinical utility in the future.

What are the barriers to physical activity in patients with chronic plaque psoriasis?

BACKGROUND: Psoriasis is associated with an increased risk of cardiovascular disease. Despite recommendation that exercise is important for cardiorespiratory fitness, patients with psoriasis avoid participation in physical activities for reasons that are, as yet, unclear. OBJECTIVES: This study investigated the relationship between psoriasis-specific experiences and self-reported patterns of exercise, hypothesizing that individuals with psoriasis are less likely to engage in physical activity for reasons that are related to their psoriasis. METHODS: In total 404 patients with chronic plaque psoriasis were recruited. History, examination and physical activity were assessed for each participant. RESULTS: Overall, 52·8% (n = 188) of patients with psoriasis aged 18-65 years and 66% (n = 37) of those aged > 65 years engaged in less than the recommended amount of physical activity for cardiorespiratory fitness. As the severity and psychosocial impact of psoriasis increased, the participation in exercise (of all intensities) decreased. There was a significant negative correlation between Psoriasis Area and Severity Index and total activity in women aged 18-65 years (r = -0·19, 95% confidence interval -0·36 to 0; P = 0·04) and a significant negative correlation between physical activity and Dermatology Life Quality Index (DLQI) in all participants (r = -0·11, 95% confidence interval -0·21 to 0; P = 0·04). Individual components of the DLQI identified barriers to physical activity including skin sensitivity and reluctance to participate in leisure activities. CONCLUSIONS: Psoriasis-specific factors - severity, skin sensitivity, clothing choice, participation in social/leisure activities, and treatments - contribute to exercise avoidance and may augment the increased risk of cardiovascular disease in patients with psoriasis.