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Risk of Cardiovascular Disease Associated with Serious Mental Illness among People of African Ancestry

Margaret Salisu1, Laura Geer2, Elizabeth Helzner2

  • 1Department of Medicine, SUNY Downstate Health Sciences University, Brooklyn, NY.

Ethnicity & Disease
|May 19, 2025
PubMed

Insights

Severe mental illness (SMI) significantly increases cardiovascular disease (CVD) risk in Black Americans. Early recognition and targeted interventions are crucial for this high-risk population.

Area of Science:

  • Psychiatry
  • Cardiology
  • Public Health

Background:

  • Individuals with severe mental illness (SMI), including schizophrenia, schizoaffective disorder, and bipolar disorder, face elevated cardiovascular disease (CVD) risks.
  • Black Americans exhibit a higher prevalence of cardiovascular risk factors, yet the interplay between SMI and CVD in this demographic remains underexplored.

Purpose of the Study:

  • To investigate the association between severe mental illness (SMI) and cardiovascular disease (CVD) and its risk factors in a cohort of Black Americans.
  • To determine if SMI independently predicts CVD risk in this population, even after accounting for traditional risk factors.

Main Methods:

  • The study analyzed data from 2305 participants in the African Ancestry-Genomic Psychiatric Cohort in Brooklyn, NY (2016-2020).
  • Severe mental illness (SMI) was diagnosed using the Diagnostic Interview for Psychoses and Affective Disorders.
  • Logistic regression models, adjusted for age, sex, alcohol, and tobacco use, were employed to assess associations between SMI and CVD risk factors (obesity, diabetes, hypertension, hypercholesterolemia).

Main Results:

  • Participants with SMI demonstrated significantly higher odds of CVD and associated risk factors compared to those without SMI.
  • After adjusting for all assessed CVD risk factors, SMI remained independently linked to a 57% increased likelihood of CVD (OR=1.57).
  • These associations were particularly pronounced in middle-aged adults (30-49 years), with substantially higher odds for CVD, hypercholesterolemia, and diabetes.

Conclusions:

  • Severe mental illness (SMI) is independently associated with increased cardiovascular disease (CVD) risk in Black Americans, even when controlling for other risk factors.
  • There is an urgent need for enhanced CVD screening and management strategies for African Americans with SMI.
  • Targeted clinical and lifestyle interventions are warranted to mitigate CVD risk in this vulnerable population.
Abstract

Keywords:
African American Mental HealthCardiovascular Disease and Risk FactorsHealth InequalitiesHeart DiseaseMinority Mental HealthSerious Mental Illness

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