The increased rate of mortality that is seen in patients with psoriatic arthritis (PsA) is predominantly due to atherosclerotic cardiovascular (CV) disease. CV morbidity is also increased in patients with PsA compared with the general population. This increased CV risk might be related to an increased prevalence of CV risk factors or undertreatment of CV risk factors in patients with PsA. However, CV risk factors only partially explain the elevated CV risk that is seen in this population, and it is increasingly being acknowledged that the inflammatory process in inflammatory arthritis plays a pivotal role. This is probably related to the fact that atherosclerosis also has an inflammatory component, which is accelerated in patients with inflammatory diseases. Equally, it may be expected that effective suppression of inflammation by disease-modifying anti-rheumatic drugs and/or biological agents would lower the CV risk. In summary, there are indications that PsA should be seen as a new CV risk factor and that management of CV risk is mandatory in patients with the condition. Adv Psor Inflamm Skin Dis 2009;1(2):35–39.