Aim. To identify the disturbances of vegetative heart regulation and their associations with systemic inflammation activity in patients with psoriatic arthritic (PsA). Material and methods. The main group (MG) included 32 PsA patients without cardiovascular disease, CVD (mean age 44,62 +/- 11,6 years; mean PsA duration 10,32 +/- 10,2 years; 52,3% men). The control group (CG) included 25 healthy volunteers (mean age 40,33 +/- 11,8 years; 49,1% men). Time and spectral parameters of heart rate variability (HRV) were assessed. PsA activity was assessed by DAS index, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and fibrinogen (FG) levels. Cardiovascular risk (CVR) was calculated, based on the following parameters: lipid spectr arterial hypertension, body mass index, and family history of CVD. Results. Compared to CG, all H RV parameters were affected in MG patients (p<0,01). HRV parameters were associated with PsA activity (ESR, CRP, FG, enthesitis), as well as with CVD risk factors (dyslipidemia, age). Conclusion. In PsA patients, disturbed vegetative heart regulation was manifested in reduced H RV and activated sympathetic HRV component. These disturbances were associated with traditional CVD risk factors and systemic inflammation activity.