A comprehensive cardiovascular disease risk profile in patients with schizophrenia

Patients with schizophrenia are physically inactive and have high prevalence of cardiovascular disease (CVD). Peak oxygen uptake (V̇O_2peak ) is one of the strongest predictors for CVD, yet is rarely investigated in this patient population, and how V̇O_2peak relates to other conventional CVD risk measures in this population is unclear. We measured treadmill V̇O_2peak along with daily physical activity assessed by triaxial accelerometry, body mass index (BMI), waist circumference, blood pressure, lipid profiles, and glucose in 48 outpatients (28 men, 35 ± 10 (SD) years; 20 women, 35 ± 12 years), diagnosed with schizophrenia, schizotypal, or delusional disorders (ICD-10; F20-29). The patients were compared with 48 age- and sex-matched healthy references (±2 years) and normative data from the population. V̇O_2peak was 34.5 ± 8.7 mL/kg/min (men) and 26.4 ± 7.0 mL/kg/min (women), which was 27% and 30% lower than healthy references, respectively (both P < 0.01). V̇O_2peak was not associated with daily physical activity in men while a weak association was seen in women (steps per day: r²  = 0.26; counts per minute: r²  = 0.25; P < 0.05). BMI (26.0 ± 6.1 kg/m² ) revealed that patients were moderately overweight with a waist circumference of 103 ± 17 cm. Lipid- and glucose levels, and blood pressure were all within normative range. Our data advocate the utilization of V̇O_2peak assessment for CVD risk profile determination in patients with schizophrenia. Daily physical activity was poorly and inconsistently related to V̇O_2peak, suggesting increased daily physical activity might not translate into improved V̇O_2peak and CVD risk reduction.