A Cardiovascular Risk Optimization Program in People With Schizophrenia: A Pilot Randomized Controlled Clinical Trial

Area of Science:

• Cardiology
• Psychiatry
• Public Health

Background:

• Cardiovascular disease is a primary cause of premature death in individuals with schizophrenia.
• Modifiable factors contributing to this risk include lifestyle, medication side effects, and comorbidities.
• Assessing interventions to mitigate cardiovascular risk in this population is crucial.

Purpose of the Study:

• To evaluate the effectiveness of a 6-month multifactorial cardiovascular risk intervention.
• To reduce cardiovascular risk (CVR) in patients diagnosed with schizophrenia.

Main Methods:

• A 2-arm, parallel, randomized clinical trial was conducted.
• Participants with uncontrolled cardiovascular risk factors (CVRFs) were assigned to an intervention (PRISCA) or control group.
• The PRISCA intervention included lifestyle promotion, CVRF management, psychotropic drug optimization, and motivational follow-up.

Main Results:

• The PRISCA group showed a significant reduction in cardiovascular risk score (REGICOR) by -0.96% (P=0.011) after 6 months.
• This represents a relative risk reduction of 20.9% in the intervention group compared to no significant change in the control group.
• Low-density lipoprotein cholesterol also significantly decreased by -27.14 mg/dL (P=0.008) in the PRISCA group.

Conclusions:

• A patient-centered, multifactorial cardiovascular risk intervention effectively improved CVR in people with schizophrenia.
• The primary mechanism for this improvement was the enhancement of the lipid profile.
• This intervention demonstrates a viable strategy for cardiovascular risk management in schizophrenia patients.