Cardiovascular risk in patients with severe mental illness in Italy

Eur Psychiatry. 2020 Oct 26;63(1):e96. doi: 10.1192/j.eurpsy.2020.94.

Abstract

Background: Patients with severe mental illness (SMI), such as schizophrenia or bipolar disorders, are more frequently affected by metabolic syndrome and cardiovascular (CV) diseases than the general population, with a significant reduction in life expectancy. Beyond metabolic syndrome, quantifying the risk of CV morbidity in the long-term may help clinicians to put in place preventive strategies. In this study, we assessed 10-year CV risk in patients with SMI and healthy individuals using an algorithm validated on the Italian general population.

Methods: Patients aged 35-69 years diagnosed with SMI were consecutively recruited from psychiatric acute care units. Single CV risk factors were assessed, and 10-year CV risk calculated by means of the CUORE Project 10-year CV risk algorithm, based on the combination of the following risk factors: age, systolic blood pressure, total and high-density lipoprotein cholesterol, diabetes, smoking habit, and hypertensive treatment. Patients' data were compared with those from the general population. The 10-year CV risk was log-transformed, and multivariable linear regression was used to estimate mean ratios, adjusting for age, and education.

Results: Three hundred patients and 3,052 controls were included in the analysis. Among men, the 10-year CV risk score was very similar between patients with SMI and the general population (mean ratio [MR]: 1.02; 95%CI 0.77-1.37), whereas a 39% increase in 10-year CV risk was observed in women with SMI compared to the general population (MR: 1.39; 95%CI 1.16-1.66).

Conclusions: In our study, women with SMI were consistently more at risk than the general population counterpart, even at younger age.

Keywords: Bipolar disorder; cardiovascular risk; schizophrenia; severe mental illness.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Bipolar Disorder / epidemiology
  • Cardiovascular Diseases / epidemiology*
  • Female
  • Health Status
  • Heart Disease Risk Factors*
  • Humans
  • Hypertension / epidemiology
  • Italy / epidemiology
  • Life Expectancy
  • Male
  • Mental Disorders / epidemiology*
  • Metabolic Syndrome / epidemiology
  • Middle Aged
  • Risk Factors
  • Schizophrenia / epidemiology