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Cardiovascular drug use and mortality in patients with schizophrenia or bipolar disorder: a Danish population-based

T M Laursen1, P B Mortensen1, J H MacCabe2

  • 1National Centre for Register-Based Research, Aarhus University, Aarhus, Denmark.

Psychological Medicine
|November 20, 2013
PubMed

Insights

Individuals with schizophrenia or bipolar disorder show decreased cardiovascular drug prescriptions and significantly higher mortality rates, especially from unnatural causes, highlighting neglected cardiovascular risk factor treatment.

Area of Science:

  • Psychiatry and Public Health
  • Cardiovascular Epidemiology

Background:

  • Cardiovascular co-morbidity is a primary driver of excess mortality in schizophrenia and bipolar disorder patients.
  • Population-based studies investigating this link are limited.

Purpose of the Study:

  • To investigate cardiovascular (CV) drug prescription rates and mortality risks in individuals with schizophrenia or bipolar disorder compared to the general population.
  • To identify potential under-treatment of CV risk factors in these patient groups.

Main Methods:

  • Utilized Danish population registers to calculate incidence rate ratios (IRRs) for CV drug use.
  • Calculated mortality rate ratios comparing patients with schizophrenia or bipolar disorder to those without prior psychiatric hospitalization.

Main Results:

  • CV prescription rates were significantly lower in patients with schizophrenia or bipolar disorder.
  • These patients faced up to 6-fold and 15-fold increased mortality from all causes or unnatural causes, respectively, particularly when untreated for CV conditions.
  • Excess mortality was lower but similar between treated and untreated individuals with prior cardiovascular disease.

Conclusions:

  • Apparent under-prescription of CV drugs in Danish patients with schizophrenia or bipolar disorder.
  • Excess mortality from unnatural causes in untreated patients suggests illness severity may confound CV treatment effects.
  • Highlights a potential neglect in treating CV risk factors within this vulnerable population.
Abstract

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