Comparative study of the characterization of cardiovascular risk, metabolic syndrome and mental illness in a Latin American population
DOI:
https://doi.org/10.69789/creaciencia.v16i1.678Keywords:
epidemiology, risk factors, cardiovascular diseases, psychiatryAbstract
Introduction. Patients with severe mental illness (SMI) are more frequently affected by metabolic syndrome and cardiovascular diseases (CVD) than the general population, with a significant reduction in life expectancy. Methodology. To assess CVD risk, the same algorithm developed in the CUORE Project was used. Means and standard deviations were used to describe continuous variables, and counts and percentages were used for categorical variables. Mean levels of CVD risk factors were standardized by sex and age using the age structure of the general population, 35 to 69 years of age; the CVD risk score was logarithmically transformed and a multivariable linear regression was employed to estimate the mean proportions, adjusting for age and education with the SPSS 21 software. Results. 300 patients and 302 controls were included in the analysis. Among men, the 10-year risk score was very similar between SMI patients and the general population (mean ratio [OR]: 1.02; 95% CI: 0.77-1.37); a 39% increase in the 10-year CV risk was observed in women with SMI compared to the general population (MR: 1.39; 95% CI: 1.16-1.66). Discussion. In this study, women with SMI were consistently at greater risk than their counterparts in the general population, even at a younger age. Conclusions. Based on the results found here, it is recommended to estimate the risk of CVD in patients with EMG
References
Correll CU, Solmi M, Veronese N, Bortolato B, Rosson S, Santonastaso P, et al. Prevalence, incidence and mortality from cardiovascular disease in patients with pooled and specific severe mental illness: a large-scale meta-analysis of 3,211,768 patients and 113,383,368 controls. World Psychiatry [Internet]. 2017 May 12;16(2):163–80. Disponible en: http://dx.doi.org/10.1002/wps.20420
Vancampfort D, Stubbs B, Mitchell AJ, De Hert M, Wampers M, Ward PB, et al. Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis. World Psychiatry [Internet]. 2015 Sep 25;14(3):339–47. Disponible en: http://dx.doi.org/10.1002/wps.20252
McCreadie RG; Scottish Schizophrenia Lifestyle Group. Diet, smoking and cardiovascular risk in people with schizophrenia: descriptive study. Br J Psychiatry [Internet]. 2003 Dic;183(6):534–9. Disponible en: http://dx.doi.org/10.1192/bjp.183.6.534
Cohn T, Prud’homme D, Streiner D, Kameh H, Remington G. Characterizing Coronary Heart Disease Risk in Chronic Schizophrenia: High Prevalence of the Metabolic Syndrome. Can J Psychiatry [Internet]. 2004 Nov;49(11):753–60. Disponible en: http://dx.doi.org/10.1177/070674370404901106
Goff DC, Sullivan LM, McEvoy JP, Meyer JM, Nasrallah HA, Daumit GL, et al. A comparison of ten-year cardiac risk estimates in schizophrenia patients from the CATIE study and matched controls. Schizophr Res [Internet]. 2005 Dic 1;80(1):45–53. Disponible en: http://dx.doi.org/10.1016/j.schres.2005.08.010
Tay YH, Nurjono M, Lee J. Increased Framingham 10-year CVD risk in Chinese patients with schizophrenia. Schizophr Res [Internet]. 2013 Jun;147(1):187–92. Disponible en: http://dx.doi.org/10.1016/j.schres.2013.03.023
Rekhi G, Khyne TT, Lee J. Estimating 10-year cardiovascular disease risk in Asian patients with schizophrenia. Gen Hosp Psychiatry [Internet]. 2016 Nov–Dic;43:46–50. Disponible en: http://dx.doi.org/10.1016/j.genhosppsych.2016.09.005
Zhao S, Xia H, Mu J, Wang L, Zhu L, Wang A, et al. 10-year CVD risk in Han Chinese mainland patients with schizophrenia. Psychiatry Res [Internet]. 2018 Jun;264:322–6. Disponible en: http://dx.doi.org/10.1016/j.psychres.2018.04.020
Damen JA, Pajouheshnia R, Heus P, Moons KGM, Reitsma JB, Scholten RJPM, et al. Performance of the Framingham risk models and pooled cohort equations for predicting 10-year risk of cardiovascular disease: a systematic review and meta-analysis. BMC Med [Internet]. 2019 Jun 13;17(1): Artículo 109 [16 p.]. Disponible en: http://dx.doi.org/10.1186/s12916-019-1340-7
Salvi V, D’Ambrosio V, Rosso G, Bogetto F, Maina G. Age-specific prevalence of metabolic syndrome in Italian patients with bipolar disorder. Psychiatry Clin Neurosci [Internet]. 2011 Feb 26;65(1):47–54. Disponible en: http://dx.doi.org/10.1111/j.1440-1819.2010.02160.x
Emmerink D, Bakker S, Van Bemmel T, Noorthoorn EO, Naarding P. Skin autofluorescence assessment of cardiovascular risk in people with severe mental illness. BJPsych Open [Internet]. 2018 Jul 25;4(4):313– 6. Disponible en: http://dx.doi.org/10.1192/bjo.2018.34
Lewis G. DSM-IV. Diagnostic and Statistical Manual of Mental Disorders, 4th edn. By the American Psychiatric Association. (Pp. 886; £34.95.) APA: Washington, DC.1994. Psychol Med [Internet]. 1996;26(3):651–2. Disponible en: http://dx.doi.org/10.1017/s0033291700035765
Giampaoli S, Palmieri L, Donfrancesco C, Lo Noce C, Pilotto L, Vanuzzo D, et al. Cardiovascular health in Italy. Ten-year surveillance of cardiovascular diseases and risk factors: Osservatorio Epidemiologico Cardiovascolare/Health Examination Survey 1998–2012. Eur J Prev Cardiol [Internet]. 2015 Sep;22(2 Suppl):9–37. Disponible en:http://dx.doi.org/10.1177/204748731558901
Palmieri L, Panico S, Vanuzzo D, Ferrario M, Pilotto L, Sega R, et al. La valutazione del rischio cardiovascolare globale assoluto: il punteggio individuale del Progetto CUORE (Evaluation of the global cardiovascular absolute risk: the Progetto CUORE individual score). Ann Ist Super Sanita [Internet]. 2004;40(4):393–9. Disponible en: https://www.iss.it/documents/20126/955767/404393.1111738552.pdf/b1ec87d2-49c4-64de-fb1d 6bb1f6207ecb?t=1575579800752
Giampaoli S, Palmieri L, Donfrancesco C, Panico S, Vanuzzo D, Pilotto L, et al. Cardiovascular risk assessment in Italy: the CUORE Project risk score and risk chart. Ital J Public Health [Internet]. 2007;4(2):102–9. Disponible en: https://ijphjournal.it/article/download/5885/5629
Mozaffarian D, Benjamin EJ, Go AS, Arnett DK, Blaha MJ, Cushman M, et al. Heart Disease and Stroke Statistics—2015 Update. Circulation [Internet]. 2015 Ene 27;131(4):e29–322. Disponible en: http://dx.doi.org/10.1161/cir.0000000000000152
Bobes J, Arango C, Aranda P, Carmena R, Garcia-Garcia M, Rejas J, et al. Cardiovascular and metabolic risk in outpatients with schizophrenia treated with antipsychotics: Results of the CLAMORS Study. Schizophr Res [Internet]. 2007 Feb;90(1–3):162–73. Disponible en: http://dx.doi.org/10.1016/j.schres.2006.09.025
Margari F, Lozupone M, Pisani R, Pastore A, Todarello O, Zagaria G, et al. Metabolic Syndrome: Differences between Psychiatric and Internal Medicine Patients. Int J Psychiatry Med [Internet]. 2013;45(3):203–26. Disponible en: http://dx.doi.org/10.2190/PM.45.3.a
Ratliff JC, Palmese LB, Reutenauer EL, Srihari VH, Tek C. Obese Schizophrenia Spectrum Patients Have Significantly Higher 10-Year General Cardiovascular Risk and Vascular Ages than Obese Individuals without Severe Mental Illness. Psychosomatics [Internet]. 2013 Ene–Feb;54(1):67–73. Disponible en: http://dx.doi.org/10.1016/j.psym.2012.03.001
Osborn DP, Hardoon S, Omar RZ, Holt RI, King M, Larsen J, et al. Cardiovascular Risk Prediction Models for People With Severe Mental Illness: Results From the Prediction and Management of Cardiovascular Risk in People With Severe Mental Illnesses (PRIMROSE) Research Program. JAMA Psychiatry [Internet]. 2015 Feb;72(2):143–51. Disponible en: http://dx.doi.org/10.1001/jamapsychiatry.2014.2133
Jackson CA, Kerssens J, Fleetwood K, Smith DJ, Mercer SW, Wild SH. Incidence of ischaemic heart disease and stroke among people with psychiatric disorders: retrospective cohort study. Br J Psychiatry [Internet]. 2020 Ago;217(2):442–9. Disponible en: http://dx.doi.org/10.1192/bjp.2019.250
De Rosa C, Sampogna G, Luciano M, Del Vecchio V, Pocai B, Borriello G, et al. Improving physical health of patients with severe mental disorders: a critical review of lifestyle psychosocial interventions. Expert Rev Neurother [Internet]. 2017 Jul 3;17(7):667–81. Disponible en: http://dx.doi.org/10.1080/14737175.2017.1325321
Stubbs B, Vancampfort D, Hallgren M, Firth J, Veronese N, Solmi M, et al. EPA guidance on physical activity as a treatment for severe mental illness: a meta-review of the evidence and Position Statement from the European Psychiatric Association (EPA), supported by the International Organization of Physical Therapists in Mental Health (IOPTMH). Eur Psychiatry [Internet]. 2018 Oct;54:124–44. Disponible en: http://dx.doi.org/10.1016/j.eurpsy.2018.07.004
Musil R, Obermeier M, Russ P, Hamerle M. Weight gain and antipsychotics: a drug safety review. Expert Opin Drug Saf [Internet]. 2015 Ene 2;14(1):73–96. Disponible en: http://dx.doi.org/10.1517/14740338.2015.974549
Salvi V, Barone-Adesi F, D’Ambrosio V, Albert U, Maina G. High H1-affinity antidepressants and risk of metabolic syndrome in bipolar disorder. Psychopharmacology [Internet]. 2016 Ene;233(1):49–56. Disponible en: http://dx.doi.org/10.1007/s00213-015-4085-9
Grootens KP, Meijer A, Hartong EG, Doornbos B, Bakker PR, Al Hadithy A, et al. Weight changes associated with antiepileptic mood stabilizers in the treatment of bipolar disorder. Eur J Clin Pharmacol [Internet]. 2018 Nov;74(11):1485–9. Disponible en: http://dx.doi.org/10.1007/s00228-018-2517-2
Crump C, Sundquist K, Winkleby MA, Sundquist J. Comorbidities and mortality in bipolar disorder: a Swedish national cohort study. JAMA Psychiatry [Internet]. 2013 Sep;70(9):931–9. Disponible en: http://dx.doi.org/10.1001/jamapsychiatry.2013.1394
Roach RE, Helmerhorst FM, Lijfering WM, Stijnen T, Algra A, Dekkers OM. Combined oral contraceptives: the risk of myocardial infarction and ischemic stroke. Cochrane Libr [Internet]. 2015 Ago 27;(8): Artículo CD011054 [53 p.]. Disponible en: http://dx.doi.org/10.1002/14651858.cd011054.pub2
Henderson VW, Lobo RA. Hormone therapy and the risk of stroke: perspectives 10 years after the Women’s Health Initiative trials. Climacteric [Internet]. 2012 Jun;15(3):229–34. Disponible en: http://dx.doi.org/10.3109/13697137.2012.656254
Kandasamy S, Anand SS. Cardiovascular Disease Among Women From Vulnerable Populations: A Review. Can J Cardiol [Internet]. 2018 Abr;34(4):450–7. Disponible en: http://dx.doi.org/10.1016/j.cjca.2018.01.017
Clerici M, Bartoli F, Carretta D, Crocamo C, Bebbington P, Carrà G. Cardiovascular risk factors among people with severe mental illness in Italy: A cross-sectional comparative study. Gen Hosp Psychiatry [Internet]. 2014 Nov–Dic;36(6):698–702. Disponible en: http://dx.doi.org/10.1016/j.genhosppsych.2014.08.005
Coello K, Kjærstad HL, Stanislaus S, Melbye S, Faurholt-Jepsen M, Miskowiak KW, et al. Thirty-year cardiovascular risk score in patients with newly diagnosed bipolar disorder and their unaffected first degree relatives. Aust N Z J Psychiatry [Internet]. 2019 Jul;53(7):651–62. Disponible en: http://dx.doi.org/10.1177/0004867418815987
Gugger JJ. Antipsychotic Pharmacotherapy and Orthostatic Hypotension: Identification and Management. CNS Drugs [Internet]. 2011 Ago;25(8):659–71. Disponible en: http://dx.doi.org/10.2165/11591710- 000000000-00000
Women’s Heart Foundation [Internet]. c1999–2000. Women and heart disease facts. [citado 2023 Abr 01]; [aproximadamente 2 p.]. Disponible en: https://www.womensheart.org/content/heartdisease/heart_disease_facts.asp
Sampogna G, Fiorillo A, Luciano M, Del Vecchio V, Steardo L Jr, Pocai B, et al. A Randomized Controlled Trial on the Efficacy of a Psychosocial Behavioral Intervention to Improve the Lifestyle of Patients With Severe Mental Disorders: Study Protocol. Front Psychiatry [Internet]. 2018 Jun 7;9: Artículo 235 [aproximadamente 14 p.]. Disponible en: http://dx.doi.org/10.3389/fpsyt.2018.0023
Downloads
Published
Issue
Section
License

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Los artículos de Crea Ciencia están publicados en acceso abierto bajo una licencia CC BY-NC-SA 4.0 de la Universidad Evangélica de El Salvador.