CV Risk in Schizophrenia Understimated in Standard Prediction Formulas

the Psychiatry Advisor take:

People with schizophrenia are known to be at higher risk for cardiovascular (CV) disease. Although there are CV disease risk algorithms available for the general public, the use of such an algorithm in patients with schizophrenia is unclear.

Gary McLean, PhD, a research fellow at the Institute for Health and Wellbeing at the University of Glasgow, Scotland, and colleagues compared CV disease risk scores (based on Joint British Societies [JBS] Scores), CV risk factors, rates of pre-existing CV disease and ages of first diagnosis of CV disease in those with schizophrenia relative to the general population.

Pre-existing rates of CV disease and the recording of risk factors for those without disease were higher in the schizophrenia cohort in the younger age groups, for both genders, the researchers wrote in Schizophrenia Research.  

Those with schizophrenia were more likely to have a first diagnosis of CV disease at a younger age than those without the disease, with nearly half of men with schizophrenia plus CV disease diagnosed before they reached age 55 years (schizophrenia men 46.1% vs. control men 34.8%, P<0.001; schizophrenia women 28.9% vs. control women 23.8%, P< 0.001).

However, despite high rates of CV risk factors within the schizophrenia group, only a small percentage (3.2% of men and 7.5% of women) of those with schizophrenia younger than age 55 years were correctly identified as high risk for CV disease using the JBS algorithm. Using that algorithm would misrepresent the true risk of CV disease in the schizophrenia population, according to the research.

"The JBS risk score identified only a small proportion of individuals with schizophrenia under the age of 55 as being at high risk of CVD, despite high rates of risk factors and high rates of first diagnosis of CVD within this age group," the researchers concluded.