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Meeting abstract

https://doi.org/10.15836/ccar2024.152

Cardiovascular risk factors among patients with severe mental disorders: an overview and the role of cardio-psychiatry in prevention strategies

Sergej Nadalin orcid id orcid.org/0000-0002-1601-9094 ; General Hospital “Dr. Josip Benčević”, Slavonski Brod, Croatia
Domagoj Vučić orcid id orcid.org/0000-0003-3169-3658 ; General Hospital “Dr. Josip Benčević”, Slavonski Brod, Croatia
Maja Vilibić orcid id orcid.org/0000-0002-5357-5890 ; Catholic University of Croatia, School of Medicine, Zagreb, Croatia
Vjekoslav Peitl orcid id orcid.org/0000-0003-4163-6411 ; Catholic University of Croatia, School of Medicine, Zagreb, Croatia
Luka Maršić ; General Hospital “Dr. Josip Benčević”, Slavonski Brod, Croatia
Katica Cvitkušić Lukenda orcid id orcid.org/0000-0001-6188-0708 ; General Hospital “Dr. Josip Benčević”, Slavonski Brod, Croatia
Dalibor Karlović orcid id orcid.org/0000-0001-6538-7240 ; Catholic University of Croatia, School of Medicine, Zagreb, Croatia


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Abstract

Keywords

cardiovascular diseases; control and prevention; mental disorders; risk factors

Hrčak ID:

314422

URI

https://hrcak.srce.hr/314422

Publication date:

8.2.2024.

Visits: 467 *



Individuals with severe mental disorders (SMDs) consisting of schizophrenia, major depressive disorder and bipolar affective disorder have a life expectancy 15–25 years shorter compared to individuals from the general population (1). Despite the high rate of unnatural deaths (e.g., suicides, injuries), physical conditions represent the main cause of reduced life expectancy among individuals with SMD. Evidence suggests that physical conditions account for ~70% of deaths among individuals with SMD, with cardiovascular diseases contributing 17.4% and 22.0% to the reduction in overall life expectancy in men and women, respectively (2). Lifestyle risk factors for cardiovascular diseases among individuals with SMD (e.g., unhealthy dietary pattern, cigarette smoking, reduced physical activity) are traditional risk factors that are also present, thought usually to a lesser extent, among individuals from the general population. Additional risk factors among individuals with SMD include the use of psychotropic medications (antipsychotic medications, specifically second-generation antipsychotics, antidepressants, and mood stabilizers) and biological risk factors (shared genetic loci for both SMDs and cardiovascular diseases) (3). Importantly, different cardiovascular risk factors among individuals with SMD interact by yet-undefined mechanisms which additionally complicate the relationship between SMDs and cardiovascular diseases (4). In the research literature, there is still a lack of studies on systematic assessment of cardiovascular risk factors among individuals with SMD. Furthermore, in clinical practice, comorbidity of cardiovascular diseases and psychiatric disorders is likely to be underrecognized and undertreated. In this work we discuss the risk factors for cardiovascular diseases among individuals with SMD, highlighting the role of multidisciplinary approach comprising psychiatry and cardiology teams in prevention strategies. We also discuss clinically significant interactions between common cardiovascular and psychotropic medications as well as (neuro)psychiatric effects of common cardiovascular medications. Finally, we provide novel insights related to the genetic relationship between SMDs and cardiovascular diseases, based on genome-wide association studies.

LITERATURE

1 

Goldfarb M, De Hert M, Detraux J, Di Palo K, Munir H, Music S, et al. Severe Mental Illness and Cardiovascular Disease: JACC State-of-the-Art Review. J Am Coll Cardiol. 2022 August 30;80(9):918–33. https://doi.org/10.1016/j.jacc.2022.06.017 PubMed: http://www.ncbi.nlm.nih.gov/pubmed/36007991

2 

Nielsen RE, Banner J, Jensen SE. Cardiovascular disease in patients with severe mental illness. Nat Rev Cardiol. 2021 February;18(2):136–45. https://doi.org/10.1038/s41569-020-00463-7 PubMed: http://www.ncbi.nlm.nih.gov/pubmed/33128044

3 

De Hert M, Detraux J, Vancampfort D. The intriguing relationship between coronary heart disease and mental disorders. Dialogues Clin Neurosci. 2018 March;20(1):31–40. https://doi.org/10.31887/DCNS.2018.20.1/mdehert PubMed: http://www.ncbi.nlm.nih.gov/pubmed/29946209

4 

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. 2017 June;16(2):163–80. https://doi.org/10.1002/wps.20420 PubMed: http://www.ncbi.nlm.nih.gov/pubmed/28498599


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