Cardiovascular disease and mortality in people with schizophrenia or antipsychotic treatment: A cohort study in

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Miguel Castillo-Sánchez1, Mireia Fàbregas Escurriola2, María Isabel Fernández Sanmartín3

  • 1Consultorio médico Cox (Departamento de Salud de Orihuela), Alicante, Spain; Grupo de trabajo de Trastornos Mentales Severos IDIAPJGol, Barcelona, Spain; Grupo de trabajo de Medicina Basada en la Evidencia de la SMUMFYC, Murcia, Spain.

Psychiatry Research
|October 22, 2021
PubMed

Insights

Schizophrenia (SZ) increases cardiovascular mortality risk independently of antipsychotic drug (TAD) treatment. People treated with TAD but without SZ face risks for all-cause and cardiovascular disease mortality.

Area of Science:

  • Cardiology
  • Psychiatry
  • Public Health

Background:

  • Individuals with schizophrenia (SZ) or on antipsychotic drugs (TAD) face elevated cardiovascular (CV) risks.
  • The specific reasons for increased CV morbidity and mortality in these populations remain unclear.
  • Longitudinal primary care studies in Spain addressing this risk are lacking.

Purpose of the Study:

  • To analyze the incidence of cardiovascular disease (CVD) and CV mortality in patients with SZ.
  • To compare CVD and CV mortality in patients with SZ versus those without SZ but on TAD (NS-TAD).
  • To investigate CVD and CV mortality risks within the Spanish primary care setting.

Main Methods:

  • A retrospective cohort study was conducted using computerized medical records and national mortality data in Spain.
  • The study followed three groups: SZ, NS-TAD, and a control group.
  • A 4-year follow-up period from 2008 to 2011 was utilized.

Main Results:

  • Schizophrenia (SZ) was identified as an independent risk factor for cardiovascular (CV) mortality.
  • SZ was not found to be an independent risk factor for non-fatal cardiovascular disease (CVD) incidence.
  • The NS-TAD group was an independent risk factor for all-cause mortality and CVD, but not specifically CV mortality.

Conclusions:

  • Findings suggest SZ confers an increased risk of CVD independent of antipsychotic drug (TAD) treatment.
  • Further research is required to understand the origins and optimal management of this elevated risk.
  • Prioritizing CVD detection and secondary prevention in these high-risk groups is crucial, necessitating enhanced primary care and mental health service collaboration.

Keywords:
Antipsychotic agentsCardiovascular diseasePrimary Health CareSchizophreniaSubstance-related disorders

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