Prevalence of cardiovascular risk factors and disease in people with schizophrenia: a population-based study

To evaluate the prevalence of cardiovascular risk factors (CV-RF) and disease (CV-D) in people with schizophrenia.

We conducted a period-prevalence study using a population-based cohort from Alberta administrative databases. Schizophrenia was identified using billing codes; all other individuals served as non-schizophrenic controls. Modifiable CV-RF (hypertension, dyslipidemia, diabetes) and established CV-D (acute coronary syndrome (ACS), chronic ischemic heart disease (IHD), heart failure (HF), stroke, arrhythmia) were identified using previously validated methods. Analyses were conducted using multivariable logistic regression.

From 1995 to 2006, 28,755 people (1.2%) were identified with schizophrenia and compared with 2,281,636 non-schizophrenic controls. Individuals with schizophrenia were older (mean age 47.6 years vs. 45.3) and had lower socioeconomic status (59% received healthcare subsidies vs. 21%; OR: 5.55; 95% CI: 5.42-5.69) than controls. Of the CV-RF, diabetes was more common in those with schizophrenia than controls, particularly in younger males (ages 30-39, 3.8% vs. 1.4%, aOR: 1.57; 95% CI: 1.30-1.91) and females (ages 30-39, 5.8% vs. 2.4%, aOR: 1.72; 95% CI: 1.44-2.04). The prevalence of CV-D was significantly higher in people with schizophrenia than controls (27% vs. 17%, OR: 1.76; 95% CI: 1.72-1.81).

On a population-wide basis, people with schizophrenia had a higher prevalence of diabetes and cardiovascular disease than those without schizophrenia, particularly at a younger age. Female sex offered no cardiovascular protection in those with schizophrenia. Our data suggest monitoring for diabetes and other cardiovascular risk factors should begin at the time of diagnosis of schizophrenia, particularly in females with schizophrenia.