Cardiovascular risk in patients admitted for psychosis compared with findings from a population-based study

Abstract

Background: Schizophrenia and related psychoses are associated with excess morbidity and mortality from cardiovascular disease (CVD). Single-site studies on CVD-related risk factors in representative samples of acutely admitted inpatients are scarce. Aims: To assess the levels of risk factors related to CVD in patients acutely admitted to hospital for symptoms of psychosis. Methods: Eligible patients aged 18–65 years were included consecutively in the Bergen Psychosis Project (BPP). CVD-related risk factors were recorded at admittance and at discharge or after 6 weeks at the latest. The recordings of 218 patients with psychosis (BPP) were compared with the findings of 50,219 subjects from the population-based Nord-Trøndelag Health Study 1995–97 (HUNT2) survey. Results: Diastolic blood pressures were higher for BPP women and men, whereas body mass indexes (BMIs) and total cholesterol levels were higher in HUNT2 women and men. On categorical measures, smoking was more prevalent in the patients compared with the HUNT2 subjects. Metabolic syndrome was present in 11.8% and 21.9% of BPP women and men, respectively. At discharge or 6 weeks from admission, 3.2% and 18.6% of BPP women and men, respectively, had metabolic syndrome. BMIs and total cholesterol levels had worsened during the inpatient treatment period. Only one patient had a diagnosis corresponding to the CVD risk found, and only four patients received antidiabetics, antihypertensives or lipid-lowering drugs. Conclusions: Some CVD-related risk factors were high in the patients at admission, some worsened and CVD risk factors seem to be suboptimally addressed, which should warrant increased awareness on the topic in clinical practice.

• Adverse effects
• Antipsychotics
• Psychosis

Acknowledgement

Trial Registration: ClinicalTrials.gov ID; URL: http://www.clinicaltrials.gov/: NCT00932529. The Nord-Trøndelag Health Study (HUNT Study) is a collaboration between HUNT Research Centre (Faculty of Medicine, Norwegian University of Science and Technology NTNU), Nord-Trøndelag County Council and the Norwegian Institute of Public Health. The authors thank research nurses Ingvild Helle and Marianne Langeland at the Research Department, Division of Psychiatry, Haukeland University Hospital, for their contributions. We also wish to thank the Division of Psychiatry, Haukeland University Hospital, for financial support, and the Clinical Departments for enthusiasm and cooperation.

Disclosure of interest

Funding support: Funding of the project was initiated by the Research Council of Norway, followed by Helse Vest RHF and Haukeland University Hospital, Division of Psychiatry.

Financial disclosure: EJ has received honoraria for lectures given in meetings arranged by Bristol-Myers Squibb, Eli Lilly and AstraZeneca, and for a contribution to an information brochure by Eli Lilly.