Individuals diagnosed with bipolar disorder, schizoaffective disorder, or schizophrenia have up to twice the risk of developing heart disease at a young age compared to those with no mental health problems. The corresponding study was published in the Journal of the American Heart Association.
Previous research indicates that people with severe mental illness are likely to die 10-20 years earlier than average, with the leading cause of death being heart disease. However, such research generally focuses on hospitalized patients, who tend to have weaker health than their outpatient counterparts.
According to the researchers behind the current study, theirs is the first to examine the prevalence of heart disease over 30 years in a large sample of outpatients diagnosed with severe mental illness (SMI).
Their study sample consisted of nearly 600,000 US citizens aged 18-75 who had visited a primary care clinic between January 2017 and June 2018, and included 1,333 people who had been diagnosed with SMI.
The researchers used data for cardiovascular risk factors such as body mass index, blood sugar, cholesterol, blood pressure, and smoking status to analyze and predict the risk of heart disease in the patients.
They used the American College of Cardiology Cardiovascular Risk scoring tool to assess 10-year risk in patients aged 40-75 years old, and the Framingham Risk Score to evaluate 30-year cardiovascular risk in patients aged 18-59 years old.
The researchers found that patients diagnosed with SMI had a significantly higher risk of developing heart problems. Their 10 and 30-year risks were estimated at 9.5% and 25%, compared to 8% and 11% for adults without a diagnosed mental illness.
They also found that 36% of those diagnosed with SMI were smokers, compared to 12% of patients without serious mental illness. Furthermore, 50% of those with serious mental illness were obese, compared to 36% of people without SMI.
The findings indicate that these differences may be due to higher rates of smoking and obesity in young adults with severe mental illness, as well as late recognition and management of cardiovascular risk factors in younger populations.
The researchers noted that increased cardiovascular risk factors among those with SMI were evident across all ages. It is thus necessary to address these risk factors among young and older patients alike.
They also noted some limitations to the study. They say, for example, that their prediction models depended on an integrated healthcare system, which may limit their use in other settings. They also had no access to social determinants of health such as income, exercise regimen, diet, and education- all of which are predictors of cardiovascular health.
Nevertheless, the researchers believe that using a 30-year cardiovascular risk prediction model is essential for preventing and managing cardiovascular risk factors in young adults with SMI. The use of this model may help decrease the prevalence of cardiovascular disease in younger populations.
“Given the shortened life span of people with SMI, and the considerable contribution of CV 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,” concluded the researchers.