Cardiovascular Risk Among Patients With Moderate-to-Severe Plaque Psoriasis in Southern Sri Lanka: A Case-Control Study

Achala Liyanage; Gayani Liyanage; Binari Wijenayake; Bandujith Yapa; Malathi Pushparani; Vijitha de Silva; Shinichi Imafuku; Sarath Lekamwasam

doi:10.7759/cureus.85057

Cardiovascular Risk Among Patients With Moderate-to-Severe Plaque Psoriasis in Southern Sri Lanka: A Case-Control Study

Cureus. 2025 May 29;17(5):e85057. doi: 10.7759/cureus.85057. eCollection 2025 May.

Authors

Achala Liyanage¹, Gayani Liyanage², Binari Wijenayake³, Bandujith Yapa⁴, Malathi Pushparani⁵, Vijitha de Silva⁶, Shinichi Imafuku⁷, Sarath Lekamwasam⁸

Affiliations

¹ Dermatology, Faculty of Medicine, University of Ruhuna, Galle, LKA.
² Pharmacology, Faculty of Medicine, University of Ruhuna, Galle, LKA.
³ Dermatology, Galle National Hospital, Galle, LKA.
⁴ Dermatology, District General Hospital - Matara, Matara, LKA.
⁵ Dermatology, District General Hospital - Hambantota, Hambantota, LKA.
⁶ Community Medicine, Faculty of Medicine, University of Ruhuna, Galle, LKA.
⁷ Dermatology, Fukuoka University, Fukuoka, JPN.
⁸ Medicine, Faculty of Medicine, University of Ruhuna, Galle, LKA.

Abstract

Introduction: Psoriasis is a chronic inflammatory skin condition associated with increased cardiovascular (CV) risk and a higher prevalence of comorbidities. The study aimed to assess CV risk and contributory factors in patients with chronic plaque psoriasis (CPP).

Methods: This case-control study included 80 patients with CPP attending selected dermatology clinics in Southern Sri Lanka, along with 80 age- and sex-matched controls from their neighbourhood. Data on demographic and disease-related factors were collected using an interviewer-administered questionnaire from consecutive patients with moderate to severe psoriasis, as defined by body surface area (BSA) and the Psoriasis Area and Severity Index (PASI). Anthropometric measurements, blood glucose, and lipid assays were conducted for both groups. Comorbidity was assessed using the Charlson Comorbidity Index (CCI) while CV risk was estimated using the Framingham Risk Score (FRS) and the Atherosclerotic Cardiovascular Disease (ASCVD) 10-year risk score.

Results: Mean (standard deviation, or SD) age of patients with CPP (n=80) was 51 (11) years, with 41 being male. The corresponding values of controls were 50 (10) years, with 41 being male. The median (interquartile range, or IQR) duration of psoriasis was 10 (6-20) years, median (IQR) BSA was 11.3% (5.5-20.4%), and median (IQR) PASI was 6.7 (5.3-10.8). Patients with psoriasis had a higher median CCI value (1 (1-3) vs. 0 (1-2); U=1819, p < 0.001) and higher occurrence of dyslipidaemia (odds ratio (OR) 5.69; confidence interval (CI): 2.03-15.93) compared to controls. Patients with CPP had higher triglycerides (TG) and triglyceride-to-high-density lipoprotein (TG/HDL) ratios compared to controls (p < 0.05 for both). Although CV risk scores were higher among patients with CPP, they did not differ significantly from those of controls.

Conclusion: Patients with CPP have higher comorbidity and unadjusted lipid levels. This highlights the need to educate healthcare professionals to adopt a more holistic approach in evaluating patients with CPP.

Keywords: ascvd; cardiovascular risk; framingham score; metabolic syndrome; psoriasis.