Mental illness linked to higher risk of cardiovascular disease

An analysis of nearly 600,000 adults found that people who are diagnosed with bipolar disorder, schizophrenia, or schizoaffective disorder may have a higher risk of developing cardiovascular disease at younger ages compared with people without these illnesses. Rebecca C. Rossom, MD, MS. a senior research investigator in behavioral health at the Center for Chronic Care Innovation at HealthPartners Institute in Minneapolis, Minn. noted that: "Previous research has indicated that people diagnosed with a serious mental illness die 10 to 20 years earlier than the general population, and their leading cause of death is heart disease," said study lead author. "Our study focused on the contribution of cardiovascular risk factors, such as blood pressure, cholesterol, blood sugar, body mass index, and smoking status, to compare overall heart disease risk for people with and without serious mental illness." Read: Long-term cardiovascular risks are substantial in COVID-19 survivors The analysis evaluated data from nearly 600,000 people who were ages 18 to 75. Close to 2% had a diagnosis of serious mental illness including bipolar disorder (70%), schizoaffective disorder (18%), and schizophrenia (12%). People with serious mental illnesses were more likely to be insured by Medicaid or Medicare, female, younger, Black, Native American, Alaskan, or multiracial. The researchers used prediction models to provide a standardized metric to assess cardiovascular risk factors and predict the likelihood of a stroke, heart attack, or cardiovascular death. They used the American College of Cardiology/American Heart Association's atherosclerotic cardiovascular risk scoring tool to assess 10-year risk in adults ages 40 to 75, and the Framingham Risk Score to estimate 30-year cardiovascular risk among adults ages 18 to 59. They reported the following results in the Journal of the American Heart Association: Adults with one serious mental illness had an estimated 10-year cardiovascular risk level of 9.5%, compared with 8% for adults without a mental condition. The estimated 30-year risk of cardiovascular disease was 25% among people with one of the three serious mental illnesses, compared with 11% of people without a serious mental illness. The increased risk of heart disease was evident even in people ages 18 to 34 with a serious mental illness. People with bipolar disorder had the highest 10-year cardiovascular risk. People with the schizoaffective disorder had the highest 30-year cardiovascular risk. People with a serious mental illness were three times more likely to be current smokers (36%) compared with people without mental illness (12%). Fifty percent of people with a serious mental illness met the criteria for obesity compared with 36% of people without a serious mental illness. People with a serious mental illness had double the rate of diabetes (14%) than people without serious mental illness (7%). Fifteen percent of adults with a serious mental illness had hypertension compared with 13% of those without a serious mental illness. "Even at younger ages, people with serious mental illness had a higher risk of heart disease than their peers, which highlights the importance of addressing cardiovascular risk factors for these individuals as early as possible," Dr. Rossom said. "Interventions to address heart disease risk for these individuals are maximally beneficial when initiated at younger ages. Read: Spironolactone not associated with a significant increase in cancer risk "We encourage health care systems and clinicians to use the 30-year cardiovascular risk estimates for young adults with serious mental illness, as these may be used starting at age 18," she said. "Right now, estimates of 10-year heart disease risk are used most frequently, and they cannot be applied until people are at least 40 years old, which is too late to start addressing heart disease risk in people with serious mental illness." Source: Serious mental illnesses tied to higher risk for heart attack and stroke. American Heart Association News. This article was originally published in our U.S. sister publication Convenient Care Clinician.

Mental illness linked to higher risk of cardiovascular disease

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