Obese schizophrenia spectrum patients have significantly higher 10-year general cardiovascular risk and vascular ages than obese individuals without severe mental illness.

Joseph C Ratliff, Laura B Palmese, Erin L Reutenauer, Vinod H Srihari, Cenk Tek
Author Information
  1. Joseph C Ratliff: Dept. of Psychiatry, Yale University School of Medicine, New Haven, CT 06519-1109, USA. joseph.ratliff@yale.edu

Abstract

BACKGROUND: Individuals with schizophrenia have a life expectancy that is 20 years less than the general population, along with high rates of obesity and cardiovascular disease (CVD) mortality.
OBJECTIVE: This study assessed the 10-year general CVD risk and vascular ages of 106 obese schizophrenia spectrum patients and 197 demographically matched obese controls without severe mental illness (SMI) from the National Health and Nutrition Examination Survey (NHANES).
METHODS: Vascular age and general CVD risk were calculated using the Framingham global CVD calculator, which incorporates age, sex, total and HDL cholesterol levels, systolic blood pressure, smoking status, and diabetes or hypertension treatment.
RESULTS: Obese schizophrenia spectrum patients had a mean vascular age that was 14.1 years older than their mean actual age, whereas obese NHANES participants had only a 6.7-year difference. The probability of experiencing a CVD event within the next 10 years was 10.7% for obese patients and 8.5% for obese NHANES participants.
CONCLUSION: These findings suggest that schizophrenia spectrum patients experience increased metabolic risk independent of weight. Primary care clinicians can utilize general CVD risk and vascular age scores to communicate metabolic risk more easily and to help make treatment decisions.

References

  1. Arch Intern Med. 2002 Sep 9;162(16):1867-72 [PMID: 12196085]
  2. Am Heart J. 2005 Dec;150(6):1115-21 [PMID: 16338246]
  3. J Clin Psychiatry. 2006 Apr;67(4):547-53 [PMID: 16669719]
  4. J Clin Pharmacol. 2011 May;51(5):631-8 [PMID: 20410451]
  5. Schizophr Res. 2005 Dec 1;80(1):45-53 [PMID: 16198088]
  6. Can J Psychiatry. 2004 Nov;49(11):753-60 [PMID: 15633853]
  7. J Psychopharmacol. 2010 Nov;24(4 Suppl):37-50 [PMID: 20923919]
  8. Schizophr Res. 2005 Dec 1;80(1):19-32 [PMID: 16137860]
  9. Ann Intern Med. 2003 Jan 7;138(1):24-32 [PMID: 12513041]
  10. Schizophr Res. 2007 Feb;90(1-3):162-73 [PMID: 17123783]
  11. Circulation. 2011 Feb 1;123(4):e18-e209 [PMID: 21160056]
  12. Schizophr Res. 2006 Sep;86(1-3):15-22 [PMID: 16884895]
  13. Circulation. 1998 May 12;97(18):1837-47 [PMID: 9603539]
  14. N Engl J Med. 2005 Sep 22;353(12):1209-23 [PMID: 16172203]
  15. Am J Psychiatry. 2010 Jun;167(6):686-93 [PMID: 20360319]
  16. Nat Rev Endocrinol. 2011 Oct 18;8(2):114-26 [PMID: 22009159]
  17. Circulation. 2008 Feb 12;117(6):743-53 [PMID: 18212285]
  18. Acta Psychiatr Scand. 2009 Jan;119(1):4-14 [PMID: 19133915]
  19. Eur Heart J. 2011 Jun;32(11):1345-61 [PMID: 21531743]
  20. J Psychiatr Res. 2009 Sep;43(13):1106-11 [PMID: 19398113]
  21. BMJ. 2007 Jul 21;335(7611):136 [PMID: 17615182]
  22. BMJ. 2009 Feb 17;338:b480 [PMID: 19224884]
  23. Disabil Rehabil. 2012;34(1):1-12 [PMID: 21957908]
  24. Circulation. 2009 Oct 20;120(16):1640-5 [PMID: 19805654]
  25. Diabetes Obes Metab. 2009 Jul;11(7):665-79 [PMID: 19476478]
  26. PLoS One. 2011;6(5):e19590 [PMID: 21611123]
  27. Soc Psychiatry Psychiatr Epidemiol. 2007 Oct;42(10):787-93 [PMID: 17721669]
  28. Schizophr Res. 2011 Apr;127(1-3):257-61 [PMID: 21242060]
  29. Lancet. 2005 Jan 29-Feb 4;365(9457):434-41 [PMID: 15680460]
  30. JAMA. 2001 May 16;285(19):2486-97 [PMID: 11368702]
  31. J Clin Psychiatry. 2009 Jul;70(7):1041-50 [PMID: 19653979]
  32. Lancet. 2011 Mar 26;377(9771):1085-95 [PMID: 21397319]
  33. Psychol Med. 1999 May;29(3):697-701 [PMID: 10405091]
  34. Psychiatr Serv. 2007 Apr;58(4):544-50 [PMID: 17412858]
  35. JAMA. 2007 Feb 14;297(6):611-9 [PMID: 17299196]
  36. World Psychiatry. 2009 Feb;8(1):15-22 [PMID: 19293950]
  37. JAMA. 2007 Dec 12;298(22):2654-64 [PMID: 18073361]

Grants

  1. R01 MH080048/NIMH NIH HHS
  2. R01 MH080048-01A2/NIMH NIH HHS
  3. MH080048-02/NIMH NIH HHS

MeSH Term

Adult
Age Factors
Aged
Cardiovascular Diseases
Case-Control Studies
Diabetes Mellitus
Female
Humans
Hypercholesterolemia
Hypertension
Life Expectancy
Male
Metabolic Syndrome
Middle Aged
Obesity
Psychotic Disorders
Risk Assessment
Risk Factors
Schizophrenia
Sex Factors
Smoking

Word Cloud

Created with Highcharts 10.0.0CVDriskobeseschizophreniageneralpatientsagevascularspectrumyearsNHANEScardiovascular10-yearageswithoutseverementalillnesstreatmentObesemeanparticipants10metabolicBACKGROUND:Individualslifeexpectancy20lesspopulationalonghighratesobesitydiseasemortalityOBJECTIVE:studyassessed106197demographicallymatchedcontrolsSMINationalHealthNutritionExaminationSurveyMETHODS:VascularcalculatedusingFraminghamglobalcalculatorincorporatessextotalHDLcholesterollevelssystolicbloodpressuresmokingstatusdiabeteshypertensionRESULTS:141olderactualwhereas67-yeardifferenceprobabilityexperiencingeventwithinnext7%85%CONCLUSION:findingssuggestexperienceincreasedindependentweightPrimarycareclinicianscanutilizescorescommunicateeasilyhelpmakedecisionssignificantlyhigherindividuals

Similar Articles

Cited By