Healthy lifestyle habits and 10-year cardiovascular risk in schizophrenia spectrum disorders: An analysis of the impact of smoking tobacco in the CLAMORS schizophrenia cohort

Abstract 

Aim

We analysed the impact of tobacco smoking over several healthy lifestyle habits along with the impact on 10-years cardiovascular event (CVE) risk in the CLAMORS schizophrenia cohort.

Methods

This analysis was performed within the scope of the CLAMORS study which included consecutive outpatients meeting DSM-IV criteria for schizophrenia spectrum disorder. Beside smoking history, data on usual healthy lifestyle habits included current exercise, saturated fat sparing diet, low-caloric diet, and daily dietary fibre, salt, caffeine and alcohol consumption were recorded. The 10-year CVE risk was calculated with Framingham function.

Results

1704 patients (61.1% male), 18 to 74years were examined. Prevalence of smoking was 54.54% (95% CI: 52.16%–56.90%) significantly higher than in age and sex matched general population subjects, 31.51% (31.49%–31.52%); OR=2.61 (2.37–2.87, p<0.0001). After controlling by confounders smokers showed a 10-year CVE risk excess versus non-smokers of 2.63 (2.16–3.09), p<0.001. Smoking cessation would reduce the likely of high/very high 10-year CVE risk (above 10%) by near 90% [OR=0.10 (0.06–0.18), p<0.0001]. Also, smokers were more likely to consume alcohol daily [4.13 (3.07–5.54), p<0.0001] and caffeine [3.39 (2.72–4.23), p<0.0001] than non-smoker patients with schizophrenia, and less likely to avoid daily consumption of salt [0.58 (0.43–0.78), p<0.0001], saturated fat [0.71 (0.56–0.91), p=0.006], high fibre diet [0.67 (0.53–0.84), p=0.001], or to follow a low-caloric diet [0.63 (0.48–0.81), p<0.0001]. Smokers also were less likely to do exercise habitually [0.62 (0.48–0.82, p=0.001].

Conclusion

Compared with the general population, patients with schizophrenia showed significant higher prevalence of smoking. Smokers who stop smoking would benefit by a near 90% reduction in the likely of 10-year cardiovascular event risk above 10%.

Keywords: Schizophrenia, Outpatients, Lifestyle habits, Smoking tobacco, General population, Cardiovascular risk, Framingham function, Spain