[Cardiovascular risk factors in severely ill psychiatric patients]

The most recent European guidelines for coronary heart disease (CHD) prevention acknowledges that stress/anxiety and depression are independent risk factors for CHD. The Psychiatric Patients Health Status Study is a transversal study on the health condition of 1.590 serious psychiatric patients. We've built a database containing historical, clinical and laboratory data of the 1.374 subjects aged > 30 years. 25% of them has a family history of CHD and 7% of cerebrovascular disease. 1.4% has clinical history of CHD, while 5.7% has a clinical history of cerebrovascular disease. The 37.3% is cigarette smoker. Moreover, in this population there is a high prevalence of overweighting (M: 25.30%; F: 11.30%) and obese (M: 13.25%; F: 5.82%) subjects. Furthermore, we observed a 40% of hypertensive patients among that only one half with controlled blood pressure level and 6.5% of diabetics or glucose intolerant among that 78% with uncontrolled basal glucose level. Finally, 40% of these subjects is affected by dyslipidaemia and 98% of them has uncontrolled plasma lipid levels. 16% of patients accounts more than one pharmacologically treatable CHD risk factor. A non-lethal CHD event in these patients could really increases the risk of non-compliance and of drug-drug interactions because of the high number of drugs needed to treat both kind of disease. Thus, we find unethical do not treat hypertension, dyslipidemia and diabetes in severe psychiatric patients.