Collaborative research from Perelman School of Medicine at the University of Pennsylvania has shown that psoriasis patients have an increased risk of heart attack, stroke, and cardiovascular death, especially if the psoriasis is moderate to severe. Now, Penn researchers have discovered the potential underlying mechanism by which the inflammatory skin disease impacts cardiovascular health. In two new studies presented at the 2011 American Heart Association Scientific Sessions (November 12-16, 2011) in Orlando, Florida, Penn researchers show that the systemic inflammatory impact of psoriasis may alter both the makeup and numbers of cholesterol particles, as well as impair the function of high-density lipoprotein (HDL), the "good" cholesterol. "Anecdotally, many researchers have observed that HDL levels may be lower in states of inflammation, such as rheumatoid arthritis, psoriasis, and even obesity," said lead study author Dr. Nehal Mehta, director of Inflammatory Risk in Preventive Cardiology at Penn. "However, these new findings suggest that in addition to lower levels, chronic inflammation associated with conditions like psoriasis may change the composition and decrease the function of HDL as well." In the current studies, researchers enrolled 78 patients with psoriasis and 84 control subjects. In the first study, the authors measured fasting lipid levels and examined the number and size of cholesterol particles using nuclear magnetic resonance (NMR) spectroscopy. This analysis revealed that patients with psoriasis had a higher number of smaller LDL particles, or "bad" cholesterol, which was independent of traditional risk factors and obesity.