An international study of more than 3.2 million people with severe mental illness has revealed a substantially increased risk for developing cardiovascular disease compared to the general population.
Led by King’s College London, the research shows that people with severe mental illness (SMI), including schizophrenia, bipolar disorder, and major depression, have a 53 percent higher risk for having cardiovascular disease, with a 78 percent higher risk of developing cardiovascular disease over the longer term.
Their risk of dying from the disease was also 85 percent higher than people of a similar age in the general population, according to researchers.
The study’s findings highlight the importance of regularly screening SMI patients for cardiovascular risk and also point towards a number of potentially modifiable risk factors, according to researchers.
The researchers noted that it is well documented that people with SMI die 10 to 15 years earlier than the general population, largely due to cardiovascular disease, including heart disease, heart attack, and stroke.
According to researchers, this new study is the largest ever meta-analysis of SMI and cardiovascular disease, including more than 3.2 million patients and more than 113 million people from the general population.
The researchers examined 92 studies across four continents and 16 different countries, including the US, UK, France, Australia, and Sweden. They found that 10 percent of people with SMI had cardiovascular disease, with rates slightly higher in schizophrenia (11.8 percent) and depression (11.7 percent) than bipolar disorder (8.4 percent).
Those with SMI had a substantially increased risk for developing cardiovascular disease over time, the study found.
The researchers said they identified some important factors that increase the risk for cardiovascular disease, including antipsychotic use and higher body mass index. Based on these results, it is crucial that clinicians, where possible, choose antipsychotics with lower side effects related to weight gain, high blood pressure, and glucose abnormalities, the researchers cautioned.
Clinicians should also screen for emerging and existing cardiovascular diseases, as well as proactively managing risk factors such as weight and body mass index, the researchers added.
“These findings are a stark reminder that people with SMI are being left behind, at a time when the health of the general population as a whole appears to be benefitting from public health initiatives to reduce the burden of cardiovascular disease,” said Dr. Brendon Stubbs from the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King’s College London.
“We found that the prevalence of cardiovascular disease in people with severe mental illness was higher in more recent studies, which suggests that our efforts so far have been unsuccessful in reducing the health gap between people with SMI and the general population.”
“People with SMI die much earlier than those without these disorders, yet the majority of these premature deaths may be preventable with care that prioritizes lifestyle changes, such as exercise, better nutrition and stopping smoking, along with cautious prescribing of antipsychotics,” he concluded.
The study was published in World Psychiatry.
Source: King’s College London