What is the link between Hidradenitis Suppurativa (HS) and cardiovascular disease?

HS is a chronic inflammatory skin condition that shares underlying inflammatory pathways with cardiovascular diseases. This systemic inflammation contributes to an increased risk of conditions like atherosclerosis, heart attack, and stroke in people with HS.

What are the key cardiovascular risks for HS patients?

Patients with HS have a higher prevalence of traditional cardiovascular risk factors such as obesity, diabetes, hypertension, and dyslipidemia. They also face an increased risk of major adverse cardiac events (MACEs), including myocardial infarction, ischemic stroke, and heart failure.

How does inflammation contribute to cardiovascular risk in HS?

Chronic systemic inflammation, a hallmark of HS, plays a crucial role in the development and progression of atherosclerosis. Inflammatory mediators released in HS can damage blood vessel walls, promote plaque formation, and contribute to endothelial dysfunction, all of which increase cardiovascular risk.

What can HS patients do to reduce their cardiovascular risk?

Managing cardiovascular risk in HS involves a multi-faceted approach. This includes optimizing HS treatment to reduce inflammation, adopting a healthy lifestyle (diet, exercise, smoking cessation), managing traditional risk factors like blood pressure and cholesterol, and regular screening for cardiovascular disease.

Should HS patients be screened for cardiovascular disease?

Yes, given the increased risk, HS patients should undergo regular screening for cardiovascular risk factors and diseases. Early identification and aggressive management of these risks can help prevent adverse cardiovascular outcomes. Consultation with a cardiologist may be recommended, especially for those with severe HS or additional risk factors.

Comorbidity Deep-Dive

Hidradenitis Suppurativa and Increased Cardiovascular Risk

Hidradenitis Suppurativa (HS) is more than just a skin condition - it\'s a systemic inflammatory disease that significantly elevates the risk of cardiovascular complications. Understanding this critical link is vital for comprehensive patient care.

2.06x

Higher MI Risk for HS Patients [1]

1.95x

Higher MACEs Risk for HS Patients [1]

47.3%

Severe HS Patients with Obesity [2]

23.2%

Achieve BP/HbA1c/LDL Control [2]

The Inflammatory Bridge

The chronic, systemic inflammation characteristic of Hidradenitis Suppurativa doesn\'t just affect the skin; it acts as a crucial link to cardiovascular disease. This persistent inflammation can damage blood vessels, promote plaque buildup, and contribute to a higher burden of traditional cardiovascular risk factors, accelerating the development of heart-related conditions.

Understanding the Connection: HS and Your Heart

Systemic Inflammation

HS is driven by chronic inflammation that extends beyond the skin. This systemic inflammatory state, characterized by elevated cytokines like TNF-alpha and IL-6, directly contributes to endothelial dysfunction and arterial stiffness, key precursors to atherosclerosis.

Shared Risk Factors

Patients with HS often have a higher prevalence of traditional cardiovascular risk factors, including obesity, metabolic syndrome, type 2 diabetes, hypertension, and dyslipidemia. These factors, exacerbated by chronic inflammation, create a perfect storm for accelerated cardiovascular disease development.

Atherosclerosis Acceleration

The inflammatory environment in HS promotes the formation and progression of atherosclerotic plaques. This leads to narrowing and hardening of arteries, increasing the risk of myocardial infarction (heart attack), stroke, and peripheral artery disease at an earlier age and with greater severity than in the general population.

Managing Cardiovascular Risk in HS: A Proactive Approach

Given the heightened risk, proactive management of cardiovascular health is crucial for individuals with HS. This involves a combination of lifestyle modifications, vigilant monitoring, and, when necessary, medical interventions.

Area of Focus	Key Strategies for HS Patients
Inflammation Control	Optimize HS treatment to reduce systemic inflammation (e.g., biologics, oral medications).
Lifestyle Modifications	Adopt a heart-healthy diet, engage in regular physical activity, achieve and maintain a healthy weight, and cease smoking.
Blood Pressure Management	Regularly monitor blood pressure and manage hypertension through lifestyle changes or medication if needed.
Cholesterol and Lipids	Monitor cholesterol levels and manage dyslipidemia with diet, exercise, and statins if prescribed.
Diabetes Management	Screen for and rigorously manage type 2 diabetes to prevent microvascular and macrovascular complications.
Regular Screening	Undergo periodic cardiovascular risk assessments, including lipid panels, blood pressure checks, and potentially advanced imaging.

Warning Signs and When to Seek Help

It\'s crucial for individuals with HS to be aware of potential cardiovascular warning signs and to seek prompt medical attention if they experience any of the following:

Chest pain or discomfort (angina)
Shortness of breath, especially with exertion
Palpitations or irregular heartbeats
Swelling in the legs, ankles, or feet
Dizziness or lightheadedness
Sudden weakness or numbness on one side of the body (stroke symptoms)
Severe headache with no known cause

Care Coordination is Key

Managing HS and cardiovascular risk requires a coordinated approach between your dermatologist, primary care physician, and potentially a cardiologist. Ensure all your healthcare providers are aware of your HS diagnosis and its associated risks.

Rohan TZ, Hafer R, Duong T, Dasgupta R, Yang S. Hidradenitis Suppurativa Is Associated with an Increased Risk of Adverse Cardiac Events and All-Cause Mortality. J Clin Med. 2025;14(4):1110. doi:10.3390/jcm14041110
Dons M, Dempsey A, Carlucci PM, et al. Cardiometabolic Risk Factors and Cardiovascular Risk in Hidradenitis Suppurativa. JAMA Dermatol. 2025;161(10):1087-1090. doi:10.1001/jamadermatol.2025.2989
Egeberg A, Gislason GH, Hansen PR. Risk of Major Adverse Cardiovascular Events and All-Cause Mortality in Patients With Hidradenitis Suppurativa. JAMA Dermatol. 2016;152(4):429-434. doi:10.1001/jamadermatol.2015.5504
Tzellos T, Zouboulis CC, Gulliver W, et al. Cardiovascular disease risk factors in patients with hidradenitis suppurativa: a systematic review and meta-analysis of observational studies. Br J Dermatol. 2015;173(5):1142-1151. doi:10.1111/bjd.13961
Nielsen VW, Vad OB, Holgersen N, et al. Genetic Susceptibility to Hidradenitis Suppurativa and Predisposition to Cardiometabolic Disease. JAMA Dermatol. 2025;161(1):70-77. doi:10.1001/jamadermatol.2024.4604

Content reviewed for medical accuracy. Always consult a qualified healthcare provider.

Take Control of Your Health

Don\'t let Hidradenitis Suppurativa define your health journey. Proactive management of both your HS and cardiovascular risk factors can lead to a healthier, more fulfilling life.

Hidradenitis Suppurativa and Increased Cardiovascular Risk

The Inflammatory Bridge

Understanding the Connection: HS and Your Heart

Systemic Inflammation

Shared Risk Factors

Atherosclerosis Acceleration

Managing Cardiovascular Risk in HS: A Proactive Approach

Warning Signs and When to Seek Help

Care Coordination is Key

Frequently Asked Questions

Related Articles

HS and Metabolic Syndrome

HS and Hypertension

HS and Atherosclerosis

References

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