OBJECTIVES: Psoriasis increases the incidence of hypertension and cardiovascular disease. However, its effect on the course of cardiovascular disease in hypertension remains unknown. This large, population-based, matched-cohort study aimed to investigate whether patients with psoriasis and hypertension have a higher requirement for cardiovascular procedure and surgery than patients with hypertension but without psoriasis. METHODS: Patients with new-onset hypertension during 2005–2006 were identified from Taiwan National Health Insurance Research Database. Among these patients, those with psoriasis (n = 4,039) were matched in a 1:1 ratio by age and sex with patients without psoriasis. The association between psoriasis and cardiovascular interventions was examined using time-varying Cox regression models. RESULTS: The mean follow-up period was 5.62 years. Psoriasis was associated with an increased risk for cardiovascular procedure and surgery in patients with hypertension (adjusted hazard ratio [aHR] 1.28; 95% confidence interval [CI] 1.07–1.53). The aHRs were higher for women than for men, and for patients aged 50–64 years than for younger and older patients. Patients with severe psoriasis or psoriatic arthritis had higher risks of cardiovascular procedure and surgery than patients with mild psoriasis (aHR 1.22; 95%CI 0.98–1.51) or without psoriatic arthritis (aHR 1.15; 95%CI 0.84–1.58) did, although the differences were not statistically significant. CONCLUSIONS: Patients with hypertension and psoriasis had a greater requirement for cardiovascular interventions than those without psoriasis. Thus, patients with hypertension and psoriasis should be considered for more aggressive strategies for prevention of major cardiovascular disease and more intense assessments for cardiovascular interventions.