Pulse wave velocity is elevated in people with serious mental illness with vascular age advanced in two-thirds of individuals

People with serious mental illness (SMI) have a higher than average cardiovascular event rate/shortened life expectancy by up to 20 years. The higher incidence of cardiovascular events is not sufficiently accounted for by traditional risk factors. It has been established that aortic stiffness assessed with pulse wave velocity (PWV) correlates with vascular inflammation/increased risk for cardiovascular events.

We measured PWV/central blood pressure by photoplethysmography in 15 long-term psychiatry inpatients on a specialist inpatient ward, during a 5-min period of rest with the pOpmètre. The pOpmètre is a class IIa medical device, noninvasive and nonoperator dependent.

Mean age was 59.2 years (range: 26-79 years). Mean body (SD) BMI was 33.1 (7.7) kg/m². 46% of individuals were taking antihypertensive medication, and 60% lipid-lowering medication. 27% were diagnosed with type 2 diabetes and 20% with nondiabetic hyperglycaemia. Of the 11 men/four women, 60% took oral antipsychotics and 40% were on depot-antipsychotic medication. Mean (SD) estimated vascular age (63.7 years) was higher than chronological age (59.2 years) in two-thirds of people, with a greater propensity for this differential in older people. For PWV, the range was 4.0-17.5 m/s. In 10 of the 15 individuals, this was above the 90^th centile for their age decade and sex. Central blood pressure was pathologically elevated (≥140 mmHg) in 40% of cases.

We describe differences in major arterial vessel health that may account for some of the excess cardiovascular event rate/excess mortality in people with SMI.