People with severe mental illness are at a substantially increased risk for developing cardiovascular disease compared to the general population, according to a recent study.
Led by King’s College London, the research of more than 3.2 million people with severe mental illness shows that people with severe mental illness (SMI), including schizophrenia, bipolar disorder and major depression, have a 53% higher risk for having cardiovascular disease than healthy controls, with a 78% higher risk of developing cardiovascular disease over the longer term.
Their risk of dying from the disease was also 85% higher than people of a similar age in the general population.
These findings highlight the importance of regularly screening SMI patients for cardiovascular risk and also point towards a number of potentially modifiable risk factors.
It is well documented that people with SMI die 10 to 15 years earlier than the general population, largely due to cardiovascular disease, including heart disease, heart attack and stroke.
The researchers examined 92 studies across four continents and 16 different countries, including the US, UK, France, Australia and Sweden.10% of people with SMI had cardiovascular disease, with rates slightly higher in schizophrenia (11.8%) and depression (11.7%) than bipolar disorder (8.4%), with a substantially increased risk for developing cardiovascular disease over time.
The researchers identified some important factors which increase risk for cardiovascular disease, including antipsychotic use and higher body mass index. Based on these results, it is crucial that clinicians where possible choose antipsychotics with lower side effects related to weight gain, high blood pressure and glucose abnormalities.
Clinicians should also screen for emerging and existing cardiovascular diseases, as well as proactively managing risk factors such as weight and body mass index, according to the study authors.
Researcher Brendon Stubbs said that these findings are a stark reminder that people with SMI are being left behind, at a time when the health of the general population as a whole appears to be benefitting from public health initiatives to reduce the burden of cardiovascular disease.
Stubbs noted that people with SMI die much earlier than those without these disorders, yet the majority of these premature deaths may be preventable with care that prioritises lifestyle changes, such as exercise, better nutrition and stopping smoking, along with cautious prescribing of antipsychotics.
The study is published online in World Psychiatry.
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