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Updated: Aug 11, 2025

Author Spotlight: Assessing the Cardiovascular Profile of Patients with Metabolic Syndrome
Published on: September 27, 2024
Schizophrenia as a risk factor for cardiovascular and metabolic health outcomes: a comparative risk assessment
S Ali1,2, D Santomauro1,2, A J Ferrari1,2
1School of Public Health, The University of Queensland, Brisbane, Australia.
Insights
Schizophrenia significantly increases the risk of death from ischaemic heart disease (IHD), stroke, and diabetes. These conditions account for a substantial portion of premature deaths and years of life lost in individuals with schizophrenia.
Area of Science:
- Epidemiology
- Public Health
- Psychiatry
Background:
- Cardiometabolic diseases cause most premature deaths in schizophrenia patients.
- Understanding the fatal burden of IHD, stroke, and diabetes linked to schizophrenia is crucial.
Purpose of the Study:
- To quantify the fatal burden of ischaemic heart disease (IHD), stroke, and diabetes attributable to schizophrenia.
- To estimate deaths and years of life lost (YLLs) due to these conditions in schizophrenia patients.
Main Methods:
- Utilized Comparative Risk Assessment methodology from the Global Burden of Disease (GBD) study.
- Estimated pooled relative risks (RRs) for IHD, stroke, and diabetes mortality via meta-regression.
- Combined RRs with GBD schizophrenia prevalence data to calculate attributable deaths and YLLs.
Main Results:
- Pooled RRs for IHD, stroke, and diabetes mortality were 2.36, 1.86, and 4.08, respectively.
- Schizophrenia contributed to approximately 50,000 deaths and 1.5 million YLLs globally in 2019 from these conditions.
- IHD, stroke, and diabetes explained ~13% of all deaths and ~11% of YLLs attributable to schizophrenia, leaving a significant unexplained burden.
Conclusions:
- Quantifying the physical disease burden attributable to schizophrenia is vital for healthcare planning.
- This study highlights substantial excess mortality associated with schizophrenia within the GBD framework.
- Provides an evidence base for improving healthcare for individuals with schizophrenia.
Aims:
Cardiometabolic diseases are responsible for the majority of premature deaths in people with schizophrenia. This study aimed to quantify the fatal burden of ischaemic heart disease (IHD), stroke and diabetes attributable to schizophrenia.
Methods:
Comparative Risk Assessment methodology from the Global Burden of Disease (GBD) study was used to calculate attributable burden; pooled relative risks (RRs) for IHD, stroke and diabetes were estimated via meta-regression, which were combined with GBD schizophrenia prevalence estimates to calculate the deaths and years of life lost (YLLs) caused by these health outcomes that were attributable to schizophrenia. The proportion of explained all-cause fatal burden and corresponding unexplained burden was also calculated.
Results:
The pooled RRs for IHD, stroke and diabetes mortality were 2.36 [95% uncertainty interval (UI) 1.77 to 3.14], 1.86 (95% UI 1.36 to 2.54) and 4.08 (95% UI 3.80 to 4.38) respectively. Schizophrenia was responsible for around 50 000 deaths and almost 1.5 million YLLs globally in 2019 from these health outcomes combined. IHD, stroke and diabetes together explained around 13% of all deaths and almost 11% of all YLLs attributable to schizophrenia, resulting in 320 660 (95% UI 288 299 to 356 517) unexplained deaths and 12 258 690 (95% UI 10 925 426 to 13 713 646) unexplained YLLs.
Conclusions:
Quantifying the physical disease burden attributable to schizophrenia provides a means of capturing the substantial excess mortality associated with this disorder within the GBD framework, contributing to an important evidence base for healthcare planning and practice.
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