Prevalence of cardiovascular risk factors and disease in people with schizophrenia: A population-based study

Bresee, Lauren C.; Majumdar, Sumit R.; Patten, Scott B.; Johnson, Jeffrey A.

doi:10.1016/j.schres.2009.12.016

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Volume 117, Issue 1 , Pages 75-82, March 2010

Prevalence of cardiovascular risk factors and disease in people with schizophrenia: A population-based study

Lauren C. Bresee
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
- Institute of Health Economics, Edmonton, Alberta, Canada
Sumit R. Majumdar
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
- Institute of Health Economics, Edmonton, Alberta, Canada
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
Scott B. Patten
- Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
Jeffrey A. Johnson
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
- Institute of Health Economics, Edmonton, Alberta, Canada
- Corresponding author. 2-040 Health Research Innovation Facility, University of Alberta, Edmonton, Alberta, Canada T6G 1K4. Tel.: +1 780 492 7317; fax: +1 780 492 7455.

Received 9 October 2009; received in revised form 9 December 2009; accepted 14 December 2009. published online 18 January 2010.

Abstract

Objective

To evaluate the prevalence of cardiovascular risk factors (CV-RF) and disease (CV-D) in people with schizophrenia.

Method

We conducted a period-prevalence study using a population-based cohort from Alberta administrative databases. Schizophrenia was identified using billing codes; all other individuals served as non-schizophrenic controls. Modifiable CV-RF (hypertension, dyslipidemia, diabetes) and established CV-D (acute coronary syndrome (ACS), chronic ischemic heart disease (IHD), heart failure (HF), stroke, arrhythmia) were identified using previously validated methods. Analyses were conducted using multivariable logistic regression.

Results

From 1995 to 2006, 28,755 people (1.2%) were identified with schizophrenia and compared with 2,281,636 non-schizophrenic controls. Individuals with schizophrenia were older (mean age 47.6years vs. 45.3) and had lower socioeconomic status (59% received healthcare subsidies vs. 21%; OR: 5.55; 95% CI: 5.42–5.69) than controls. Of the CV-RF, diabetes was more common in those with schizophrenia than controls, particularly in younger males (ages 30–39, 3.8% vs. 1.4%, aOR: 1.57; 95% CI: 1.30–1.91) and females (ages 30–39, 5.8% vs. 2.4%, aOR: 1.72; 95% CI: 1.44–2.04). The prevalence of CV-D was significantly higher in people with schizophrenia than controls (27% vs. 17%, OR: 1.76; 95% CI: 1.72–1.81).

Conclusions

On a population-wide basis, people with schizophrenia had a higher prevalence of diabetes and cardiovascular disease than those without schizophrenia, particularly at a younger age. Female sex offered no cardiovascular protection in those with schizophrenia. Our data suggest monitoring for diabetes and other cardiovascular risk factors should begin at the time of diagnosis of schizophrenia, particularly in females with schizophrenia.

Keywords: Diabetes, Dyslipidemia, Hypertension, Sex differences