Schizophrenia and increased risks of cardiovascular disease.
OBJECTIVE
The aim of the study is to review the absolute and relative impacts of the major causes for premature mortality among patients with schizophrenia.


METHODS
We reviewed published articles on causes of mortality in the general population as well as among patients with schizophrenia.


METHODS
We selected articles which published total and cause-specific mortality rates.


METHODS
We reviewed the causes of mortality and their risk factors.


RESULTS
The average life expectancy of the general population is 76 years (72 years in men, 80 years in women), whereas the corresponding figure is 61 years (57 years in men, 65 years in women) among patients with schizophrenia. Thus, patients with schizophrenia have approximately a 20% reduced life expectancy compared with the general population. Although patients with schizophrenia are 10 to 20 times more likely than the general population to commit suicide, more than two thirds of patients with schizophrenia, compared with approximately one-half in the general population, die of coronary heart disease (CHD). The chief risk factors for this excess risk of death are cigarette smoking, obesity leading to dyslipidemia, insulin resistance and diabetes, and hypertension.


CONCLUSIONS
The chief cause of excess premature mortality among patients with schizophrenia is CHD, caused mainly by their adverse risk factor profile. Because patients with schizophrenia have less access to medical care, consume less medical care, and are less compliant with their regimens, the choice of antipsychotic drug regimens that do not further adversely affect their risk factor for CHD is a major clinical and public health challenge among patients with schizophrenia.
Hennekens
Charles H
CH
Department of Biomedical Science, Center of Excellence in Biomedical and Marine Biotechnology, Florida Atlantic University, FL, USA. profchhmd@prodigy.net
Hennekens
Alissa R
AR
Hollar
Danielle
D
Casey
Daniel E
DE
D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000401:mortality; D002423:Cause of Death; D006801:Humans; D008017:Life Expectancy; D012307:Risk Factors; D012559:Schizophrenia / Q000150:complications* / Q000401:mortality