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Cardiovascular risk factors among patients with schizophrenia, bipolar, depressive, anxiety, and personality disorders

Published online by Cambridge University Press:  23 March 2020

M. Pérez-Piñar ,
R. Mathur ,
Q. Foguet ,
S. Ayis ,
J. Robson  and
L. Ayerbe
M. Pérez-Piñar
Affiliation:
The Westborough Road Health Centre, Westcliff-on-Sea, United Kingdom
R. Mathur
Affiliation:
Centre for Primary Care and Public Health, Queen Mary university of London, London, United Kingdom
Q. Foguet
Affiliation:
Institut Universitari d’Investigació en Atenció Primària Jordi Gol, Universitat Autònoma de Barcelona, Barcelona, Spain
S. Ayis
Affiliation:
Division of Health and Social Care Research, King’s College London, London, United Kingdom
J. Robson
Affiliation:
Centre for Primary Care and Public Health, Queen Mary university of London, London, United Kingdom
L. Ayerbe*
Affiliation:
The Westborough Road Health Centre, Westcliff-on-Sea, United Kingdom Centre for Primary Care and Public Health, Queen Mary university of London, London, United Kingdom
*
* Corresponding author. at: Centre for Primary Care and Public Health, Queen Mary University of London, Yvonne Carter Building, 58 Turner Street, London E1 2AB, United Kingdom. E-mail address:[email protected] (L. Ayerbe).
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Abstract

Background

The evidence informing the management of cardiovascular risk in patients with psychiatric disorders is weak.

Methods

This cohort study used data from all patients, aged ≥ 30, registered in 140 primary care practices (n = 524,952) in London to estimate the risk of developing diabetes, hypertension, hyperlipidemia, tobacco consumption, obesity, and physical inactivity, between 2005 and 2015, for patients with a previous diagnosis of schizophrenia, depression, anxiety, bipolar or personality disorder. The role of antidepressants, antipsychotics and social deprivation in these associations was also investigated. The age at detection of cardiovascular risk factor was compared between patients with and without psychiatric disorders. Variables, for exposures and outcomes, defined from general practitioners records, were analysed using multivariate regression.

Results

Patients with psychiatric disorders had an increased risk for cardiovascular risk factors, especially diabetes, with hazard ratios: 2.42 (2.20–2.67) to 1.31 (1.25–1.37), hyperlipidemia, with hazard ratios: 1.78 (1.60–1.97) to 1.25 (1.23–1.28), and obesity. Antidepressants, antipsychotics and social deprivation did not change these associations, except for smoking and physical inactivity. Antidepressants were associated with higher risk of diabetes, hypertension and hyperlipidemia. Antipsychotics were associated with a higher risk of diabetes. Antidepressants and antipsychotics were associated with lower risk of other risk factors. Patients with psychiatric conditions have later detection of cardiovascular risk factors. The interpretation of these results should acknowledge the lower rates of detection of risk factors in mentally ill patients.

Conclusions

Cardiovascular risk factors require special clinical attention among patients with psychiatric disorders. Further research could study the effect of antidepressants and antipsychotics on cardiovascular risk factors.

Keywords

Cardiovascular diseasesSchizophreniaAntipsychotic agentsAntidepressive agentsSocioeconomic factorsCohort studies
Type
Original article
Information
European Psychiatry , Volume 35 , May 2016 , pp. 8 - 15
Copyright
Copyright © European Psychiatry 2016

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