Schizophrenia Spectrum Disorders Independently Linked to CVD

June 6, 2011
The Doctor's Channel

A 2009 study found that antipsychotic medications and lifestyle factors cannot fully explain the elevated risk for CVD in patients with schizophrenia.

Antipsychotic medications and lifestyle factors cannot fully explain the elevated risk for cardiovascular disease (CVD) observed in patients with schizophrenia spectrum disorders, according to research presented at the 2009 American Psychiatric Association annual meeting.

"We are aware of historical reports as early as the 1920s, thus pre-dating antipsychotic availability, showing that individuals with schizophrenia-spectrum disorders are more likely than the general public to develop, and die because of, CVD," Dr. Stephen Woolley told Reuters Health.

Dr. Woolley and his team are based at the Burlingame Center for Psychiatric Research and Education at Hartford Hospital in Connecticut.

The investigators noted that some biological characteristics of individuals with schizophrenia-spectrum disorders are similar to characteristics of individuals with CVD, suggesting that the two conditions might share etiologic components.

They explored this issue using data on individuals 40 to 64 years of age, free of CVD symptoms at baseline, in the Epidemiologic Catchment Area study for 1980-1985. People with schizophrenia-spectrum disorders were identified based on 18 reported symptoms, such as believing someone was watching, following or spying on them.

In their primary analysis, the researchers estimated that the adjusted odds ratio for developing one or more CVD symptom during a 1- to 2-year follow-up period among people with schizophrenia-spectrum disorders was 4.41 relative to people without schizophrenia-spectrum disorders.

In three separate analyses, they calculated that approximately 2%-8% of the risk was due to poor diet, 2%-11% was due to inactivity, and 18%-30% to smoking.

“In sum,” Dr. Woolley said, “these analyses suggest a residual elevated risk not explained by lifestyles or antipsychotics.”

Dr. Woolley emphasized that their research represents a preliminary, suggestive study. Nonetheless, he added, “We believe that, in the long run, in addition to understanding medication and genetic effects on risk of CVD, clinical goals will benefit from an understanding of all factors contributing to risk of CVD in the population of individuals with schizophrenia-spectrum disorders.”

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