Schizophrenia Often Cardiovascular Diseases

Cardiovascular disease in schizophrenia is common

11/10/2014

People who suffer from schizophrenia have a two- to threefold increased risk of dying. The most common causes of this are cardiovascular diseases or malignant tumors. Only a few patients are treated. This shows the result of a new study.

Schizophrenia patients have higher mortality rates
As the „Doctors newspaper“ With reference to a new study, patients with diseases of the schizophrenic type have a two- to threefold higher mortality rate than those without such a diagnosis. This is largely due to cardiovascular and malignant tumors associated with obesity. The reasons for this are not only the illness itself, but also factors such as poverty, unhealthy lifestyle and poor medical care. These are often associated with schizophrenia. In addition, the drug therapy of schizophrenia patients may have adverse effects on metabolic parameters. For example, some medicines have been associated with the development of the so-called metabolic syndrome in the past, which is characterized, among other things, by obesity and high blood lipid levels. In addition, it can lead to complications such as diabetes, stroke or heart attack.

Young patient examined
US researchers led by Glen Oaks' Christoph Correll have now investigated their cardiometabolic health with a group of approximately 400 young patients (15-40 years) who underwent a first schizophrenia episode. The results were in the trade magazine „JAMA Psychiatry“ released. Among the patients cared for by 34 communal psychiatric facilities across the US, 48 percent were overweight, 51 percent were smokers, 40 percent had pre-hypertension, 10 percent had high blood pressure, and 13.2 percent had metabolic syndrome. Four percent of them were pre-diabetics and three percent diabetics. There was an interaction between the duration of the psychiatric illness and the higher body mass index (BMI), the larger fat mass, the higher fat content and the larger waist circumference.

Drug treatment with significant effect
The paper writes that "the duration of treatment with antipsychotics was significantly associated with higher levels of non-HDL cholesterol, triglycerides, increased triglyceride / HDL cholesterol quotient, lower HDL levels, and lower systolic blood pressure." In particular, "olanzapine was associated with high triglyceride and insulin levels and increased insulin resistance, while quetiapine was associated with an increased ratio of triglycerides to HDL - a marker of insulin resistance". As the paper goes on to say, "On the effects of the medication, it is noted that on average, patients have not been on medication for as long as seven weeks."

Data compared to US averages
However, the data can be seen against the background of the US average values. Obesity and obesity of schizophrenia patients, for example, did not differ from those of the country. However, the proportion of smokers was significantly higher: 20 percentage points for men and 12 percentage points for women. Fat metabolism disorders were as common in patients as in controls 15 to 20 years older. But the metabolic syndrome was 89 percent more common. The same applies to the frequency of slightly elevated blood pressure.

Only a few of the patients are being treated
Only about four percent of patients received antihypertensive therapy. In addition, only 0.5 percent of subjects were treated with lipid-lowering drugs, although nearly 57 percent of subjects had at least one abnormal lipid score. Of the three percent diabetics, only 0.8 percent received antidiabetics. Correll and his colleagues write: „These results underline the importance of estimating the cardiometabolic risk situation for all patients before and during antipsychotic therapy.“ It should choose low-risk drugs and treat side effects accordingly. (Ad)