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Serious Mental Illness Linked to Cardiovascular Risk for Young Adults

10- and 30-year CV risk significantly higher in patients with bipolar disorder, schizophrenia, schizoaffective disorder

WEDNESDAY, March 9, 2022 (HealthDay News) — Patients with serious mental illness (SMI) have a significantly increased cardiovascular risk, which is evident in young adults, according to a study published online March 8 in the Journal of the American Heart Association.

Rebecca C. Rossom, M.D., from the HealthPartners Institute in Minneapolis, and colleagues compared 10-year and 30-year cardiovascular risk in primary care patients aged 18 to 75 years with and without SMI (bipolar disorder, schizophrenia, and schizoaffective disorder). Ten-year risk was estimated using atherosclerotic cardiovascular disease scores for patients aged 40 to 74 years, and 30-year risk was assessed using Framingham risk scores for patients aged 18 to 59 years. Data were included for 11,333 patients with SMI and 579,924 patients without SMI.

The researchers found that patients with SMI had significantly higher 10-year cardiovascular risk compared with patients without SMI after covariate adjustment (mean, 9.44 versus 7.99 percent). Similarly, those with SMI had significantly higher 30-year cardiovascular risk (25 percent of patients in highest-risk group compared with 11 percent of patients without SMI). Elevated body mass index and smoking were the individual cardiovascular risk factors that contributed most to increased risk. Among SMI subtypes, the highest 10-year cardiovascular risk was seen for patients with bipolar disorder, while the highest 30-year cardiovascular risk was seen for those with schizoaffective disorder.

“Given the shortened life span of people with SMI, and the considerable contribution of cardiovascular disease to earlier mortality, the data support more thorough screening and effective management of major cardiovascular risk factors for patients with SMI starting at a younger age, especially in those aged <40 years," the authors write.

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