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Increasing global burden of cardiovascular disease in general populations and patients with schizophrenia
1Department of Biomedical Sciences, Center of Excellence, Florida Atlantic University, Boca Raton; Nova Southeastern University, Fort Lauderdale; and University of Miami Miller School of Medicine, Miami, Fla, USA. profchhmd@prodigy.net
Insights
Cardiovascular disease (CVD) is a leading cause of death. Patients with schizophrenia experience higher CVD rates and premature death due to increased risk factors and reduced healthcare access.
Area of Science:
- Medical Science
- Psychiatry
- Public Health
Background:
- Cardiovascular disease (CVD) is the primary cause of mortality in developed nations, linked to risk factors like obesity, hypertension, and smoking.
- Schizophrenia patients face a significantly reduced life expectancy (15 years shorter) compared to the general population.
- CVD is a more frequent cause of premature death in schizophrenia patients than suicide.
Purpose of the Study:
- To highlight the disproportionately high burden of cardiovascular disease (CVD) in patients with schizophrenia.
- To identify the key risk factors contributing to CVD in this population.
- To inform primary prevention strategies for CVD in schizophrenia.
Main Methods:
- Comparative analysis of mortality causes and life expectancy between schizophrenia patients and the general population.
- Examination of prevalence rates for major CVD risk factors (obesity, dyslipidemia, hypertension, diabetes, smoking) in both groups.
- Review of healthcare access and compliance issues affecting schizophrenia patients.
Main Results:
- Schizophrenia patients have a 1.5 times higher risk of death from CVD compared to the general population.
- Elevated rates of obesity, dyslipidemia, hypertension, diabetes, and smoking are prevalent in schizophrenia patients.
- Reduced access to and utilization of medical care exacerbate CVD risk in schizophrenia.
Conclusions:
- Cardiovascular disease poses a greater threat than suicide for premature mortality in schizophrenia patients.
- Addressing modifiable risk factors and improving healthcare access are crucial for CVD prevention in schizophrenia.
- Antipsychotic medication choices should consider their impact on CVD risk factors.
Abstract:
Cardiovascular disease (CVD), which includes coronary heart, cerebrovascular, and peripheral vascular disease, is the leading cause of death in the United States and most developed countries, accounting for about 50% of all deaths. The major risk factors include obesity and its consequences, dyslipidemia, hypertension, insulin resistance leading to diabetes, and cigarette smoking. In developing countries, CVD will become the leading cause of death due to alarming increases in obesity, sedentary lifestyles, cigarette smoking, and improvements in prevention and treatment of malnutrition and infection. Compared with nonschizophrenics, patients with schizophrenia have a 20% shorter life expectancy (i.e., from 76 to 61 years). In general populations, about 1% die from suicide compared with about 10% among patients with schizophrenia (relative risk = 10). For CVD, the corresponding figures are 50% and about 75% (relative risk = 1.5). In patients with schizophrenia, however, CVD occurs more frequently and accounts for more premature deaths than suicide. Patients with schizophrenia have alarmingly higher rates of obesity, dyslipidemia, hypertension, diabetes, and cigarette smoking than nonschizophrenic individuals in the general population. Compounding these data, patients with schizophrenia have less access to medical care, consume less medical care, and are less compliant. Primary prevention strategies should include the choice of antipsychotic drug regimens that do not adversely affect the major risk factors for CVD.
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