A 60-year-old with severe psoriasis was 36% more likely to have a heart attack than other people his or her age, according to a study recently published in the Journal of the American Medical Association.

While it is not completely clear why this is true, people with psoriasis often have other risk factors for heart disease, including high blood pressure, high cholesterol, obesity and diabetes, according to researchers at the University of Pennsylvania. In addition, psoriasis is caused by inflammation, which also plays a role in heart disease.

The study also found that a 40-year-old with severe psoriasis was more than two times more likely to have a heart attack than someone that age without the condition. The study’s findings emphasize the need to give psoriasis sufferers more assistance and encouragement for protecting and improving their heart health, researchers say.