Hostname: page-component-8448b6f56d-c47g7 Total loading time: 0 Render date: 2024-04-20T02:16:40.986Z Has data issue: false hasContentIssue false
  • English
  • Français

Prevalence and awareness of cardiovascular risk factors in patients with schizophrenia: A cross-sectional study in a low cardiovascular disease risk geographical area

Published online by Cambridge University Press:  16 April 2020

M. Bernardo ,
F. Cañas ,
J.R. Banegas ,
J. Casademont ,
Y. Riesgo ,
C. Varela  and
On behalf of the RICAVA Study Group
M. Bernardo*
Affiliation:
Clinic Schizophrenia Program, Hospital Clinic, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Villarroel 170, Esc 9, 6°Planta, 08036Barcelona, Spain
F. Cañas
Affiliation:
Hospital Dr R. Lafora, Madrid, Spain
J.R. Banegas
Affiliation:
Department of Preventive Medicine and Public Health, Faculty of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
J. Casademont
Affiliation:
Department of Internal Medicine, Hospital de Sant Pau, Barcelona, Spain
Y. Riesgo
Affiliation:
Medical Department, Bristol-Myers Squibb, Madrid, Spain
C. Varela
Affiliation:
Medical Department, Bristol-Myers Squibb, Madrid, Spain
*
*Corresponding author. E-mail address: bernardo@clinic.ub.es (M. Bernardo).
Get access

Abstract

Objective

Prevalence of cardiovascular disease is high in schizophrenia. Our aim is to estimate the prevalence of cardiovascular risk factors (CVRF) among schizophrenia patients.

Method

National cross-sectional study in patients diagnosed with schizophrenia under treatment with second generation antipsychotics and admitted to short-stay hospitalisation units.

Results

A sample of 733 consecutively admitted patients was enrolled; the most prevalent CVRFs were smoking 71% (95% CI: 67–74%) and hypercholesterolemia 66% (61–70%) followed by hypertriglyceridemia 26% (26–32%), hypertension 18% (15–21%) and diabetes 5% (4–7%). Metabolic syndrome showed 19% (95% CI: 16–23%) prevalence or, according to updated definitions (Clin Cornerstone 7 [2005] 36–45), 24% (95% CI: 20–28%). The rate of patients within the high-risk range of a 10-year fatal cardiovascular event was 6.5%. CVRFs under routine management were diabetes (60%), hypertension (28%) and, to a lesser extent, dyslipemia (14%). Treatment for CVRFs was associated to gender, men for hypertension OR = 25.34, p < 0.03 and women for diabetes OR = 0.02, p < 0.03.

Conclusion

We found that CVRFs in schizophrenia were prevalent and under-diagnosed, and thus with insufficient therapeutic management.

Keywords

Risk factorsSchizophreniaDisease managementPhysical healthComorbidity
Type
Original article
Information
European Psychiatry , Volume 24 , Issue 7 , October 2009 , pp. 431 - 441
Copyright
Copyright © Elsevier Masson SAS 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Alvarez-Sala, LASuarez, CMantilla, TFranch, JRuilope, LMBanegas, JRet al.PREVENCAT study: control of cardiovascular risk in primary care. Med Clin (Barc) 2005;124(11):406–410CrossRefGoogle ScholarPubMed
American Diabetes Association, American Psychiatric Association, American Association of Clinical Endocrinologists, North American Association for the study of Obesity. Consensus development conference on antipsychotic drugs and obesity and diabetes. J Clin Psychiatry 2004;65(2):267–72.CrossRefGoogle Scholar
American Psychiatric Association. DSM-IV-TR. Manual de Diagnostico y Estadístico de los Trastornos Mentales, cuarta edición, texto revisado. Barcelona: Editorial Masson; 2002.Google Scholar
Asociación Española de Neuropsiquiatría. Mental Health Observatory: Analysis of Mental Health Resources in Spain. Internet Publication. 2003.Google Scholar
Bobes, JArango, CAranda, PCarmena, RGarcia-Garcia, MRejas, JCardiovascular and metabolic risk in outpatients with schizophrenia treated with antipsychotics: results of the CLAMORS Study. Schizophr Res 2007;90(1-3):162–173CrossRefGoogle ScholarPubMed
Bobes, JRejas, JGarcia-Garcia, MRico-Villademoros, FGarcia-Portilla, MPFernandez, Iet al.Weight gain in patients with schizophrenia treated with risperidone, olanzapine, quetiapine or haloperidol: results of the EIRE study. Schizophr Res 2003;62(1-2):77–88CrossRefGoogle ScholarPubMed
Bushe, CPaton, CThe potential impact of antipsychotics on lipids in schizophrenia: is there enough evidence to confirm a link?. J Psychopharmacol 2005;19(6 Suppl.):76–83CrossRefGoogle ScholarPubMed
Cannon, CPBattler, ABrindis, RGCox, JLEllis, SGEvery, NRet al.American College of Cardiology key data elements and definitions for measuring the clinical management and outcomes of patients with acute coronary syndromes. A report of the American College of Cardiology Task Force on Clinical Data Standards (Acute Coronary Syndromes Writing Committee). J Am Coll Cardiol 2001;38(7):2114–2130CrossRefGoogle Scholar
Casey, DEHaupt, DWNewcomer, JWHenderson, DCSernyak, MJDavidson, Met al.Antipsychotic-induced weight gain and metabolic abnormalities: implications for increased mortality in patients with schizophrenia. J Clin Psychiatry 2004;65(Suppl. 7):4–18Google ScholarPubMed
Chobanian, AVBakris, GLBlack, HRCushman, WCGreen, LAIzzo, JL Jr.et al.The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA 2003;289(19):2560–2572CrossRefGoogle ScholarPubMed
Citrome, LYeomans, DDo guidelines for severe mental illness promote physical health and well-being?. J Psychopharmacol 2005;19(6 Suppl.):102–109CrossRefGoogle ScholarPubMed
Cohn, TPrud’homme, DStreiner, DKameh, HRemington, GCharacterizing coronary heart disease risk in chronic schizophrenia: high prevalence of the metabolic syndrome. Can J Psychiatry 2004;49(11):753–760CrossRefGoogle ScholarPubMed
Conroy, RMPyorala, KFitzgerald, APSans, SMenotti, ADe, BGet al.Estimation of ten-year risk of fatal cardiovascular disease in Europe: the SCORE project. Eur Heart J 2003;24(11):987–1003CrossRefGoogle ScholarPubMed
Correll, CUFrederickson, AMKane, JMManu, PEqually increased risk for metabolic syndrome in patients with bipolar disorder and schizophrenia treated with second-generation antipsychotics. Bipolar Disord 2008;10(7):788–797CrossRefGoogle ScholarPubMed
Curkendall, SMMo, JGlasser, DBRose, SMJones, JKCardiovascular disease in patients with schizophrenia in Saskatchewan, Canada. J Clin Psychiatry 2004;65(5):715–720CrossRefGoogle ScholarPubMed
Davidson, MRisk of cardiovascular disease and sudden death in schizophrenia. J Clin Psychiatry 2002;63(Suppl. 9):5–11Google Scholar
Expert Consensus Meeting. ‘Schizophrenia and Diabetes 2003’ Expert Consensus Meeting, Dublin, 3–4 October 2003: consensus summary. Br J Psychiatry Suppl. 2004;47:S112–4.CrossRefGoogle Scholar
Expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III). Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP). JAMA 2001 16;285(19):2486–97.CrossRefGoogle Scholar
Fleiss, JStatistical Methods for Rates and Proportions 2nd ed. 1981;Google Scholar
Green, AISchizophrenia and comorbid substance use disorder: effects of antipsychotics. J Clin Psychiatry 2005;66(Suppl. 6):21–26Google ScholarPubMed
Grundy, SMA constellation of complications: the metabolic syndrome. Clin Cornerstone 2005;7(2–3):36–45CrossRefGoogle ScholarPubMed
Gual, AContel, MSegura, LRibas, AColom, JThe ISCA (Systematic Interview of Alcohol Consumption), a new instrument to detect risky drinking. Med Clin (Barc) 2001;117(18):685–689CrossRefGoogle Scholar
Han, TSvan Leer, EMSeidell, JCLean, MEWaist circumference action levels in the identification of cardiovascular risk factors: prevalence study in a random sample. BMJ 1995;311(7017):1401–1405CrossRefGoogle Scholar
Henderson, DCSchizophrenia and comorbid metabolic disorders. J Clin Psychiatry 2005;66(Suppl. 6):11–20Google ScholarPubMed
Hennekens, CHHennekens, ARHollar, DCasey, DESchizophrenia and increased risks of cardiovascular disease 1. Am Heart J 2005;150(6):1115–1121CrossRefGoogle Scholar
Instituto Nacional de Estadística. Padrón municipal de habitantes. Anuario estadístico de España 2004[(2.1 Población por comunidades autónomas 2003)]. 2006.Google Scholar
Kato, MMCurrier, MBVillaverde, OGonzalez-Blanco, MThe relation between body fat distribution and cardiovascular risk factors in patients with schizophrenia: a cross-sectional pilot study. Prim Care Companion J Clin Psychiatry 2005;7(3):115–118Google ScholarPubMed
Lehman, AFLieberman, JADixon, LBMcGlashan, THMiller, ALPerkins, DOet al.Practice guideline for the treatment of patients with schizophrenia, second edition. Am J Psychiatry 2004;161(2 Suppl.):1–56Google ScholarPubMed
Marder, SREssock, SMMiller, ALBuchanan, RWCasey, DEDavis, JMet al.Physical health monitoring of patients with schizophrenia. Am J Psychiatry 2004;161(8):1334–1349CrossRefGoogle ScholarPubMed
McEvoy, JPMeyer, JMGoff, DCNasrallah, HADavis, SMSullivan, Let al.Prevalence of the metabolic syndrome in patients with schizophrenia: baseline results from the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) schizophrenia trial and comparison with national estimates from NHANES III. Schizophr Res 2005;80(1):19–32CrossRefGoogle ScholarPubMed
Muck-Jorgensen, PMors, OMortensen, PBEwald, HThe schizophrenic patient in the somatic hospital. Acta Psychiatr Scand Suppl 2000;407:96–99CrossRefGoogle Scholar
Osby, UCorreia, NBrandt, LEkbom, ASparen, PMortality and causes of death in schizophrenia in Stockholm county. Sweden. Schizophr Res 2000;45(1–2):21–28CrossRefGoogle ScholarPubMed
Paton, CEsop, RYoung, CTaylor, DObesity, dyslipidaemias and smoking in an inpatient population treated with antipsychotic drugs. Acta Psychiatr Scand 2004;110(4):299–305CrossRefGoogle Scholar
Rejas, JBobes, JArango, CAranda, PCarmena, RGarcia-Garcia, MConcordance of standard and modified NCEP ATP III criteria for identification of metabolic syndrome in outpatients with schizophrenia treated with antipsychotics: a corollary from the CLAMORS study. Schizophr Res 2008;99(1–3):23–28CrossRefGoogle ScholarPubMed
Ryan, MCThakore, JHPhysical consequences of schizophrenia and its treatment: the metabolic syndrome. Life Sci 2002;71(3):239–257CrossRefGoogle ScholarPubMed
Saiz, RJBobes, GJVallejo, RJGiner, UJGarcia-Portilla Gonzalez, MPConsensus on physical health of patients with schizophrenia from the Spanish Societies of Psychiatry and Biological Psychiatry. Actas Esp Psiquiatr 2008;36(5):251–264Google Scholar
Sokolow, MLyon, TThe ventricular complex in left ventricular hypertrophy as obtained by unipolar precordial and limb leads. Am Heart J 1949;37:161–186CrossRefGoogle ScholarPubMed
Taylor, DMDuncan-McConnell, DRefractory schizophrenia and atypical antipsychotics. J Psychopharmacol 2000;14(4):409–418CrossRefGoogle ScholarPubMed
The American Diabetes Association. http://wwwdiabetesorg/homejsp 2009 [cited 6 Oct 2005];Available from: URL: http://www.diabetes.org/home.jsp.Google Scholar
Weiden, PJMackell, JAMcDonnell, DDObesity as a risk factor for antipsychotic noncompliance. Schizophr Res 2004;66(1):51–57CrossRefGoogle ScholarPubMed
WHO/MSD/MSB/00.3. Guide to drug abuse epidemiology. 2006. p. 403–6.Google Scholar
Wirshing, DASchizophrenia and obesity: impact of antipsychotic medications. J Clin Psychiatry 2004;65(Suppl. 18):13–26Google ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.