Minimising metabolic and cardiovascular risk in schizophrenia: diabetes, obesity and dyslipidaemia.
People with schizophrenia are at greater risk of obesity, Type 2 diabetes, dyslipidaemia and hypertension than the general population. This results in an increased incidence of cardiovascular disease (CVD) and reduced life expectancy, over and above that imposed by their mental illness through suicide. Several levels of evidence from data linkage analyses to clinical trials demonstrate that treatment-related metabolic disturbances are commonplace in this patient group, and that the use of certain second-generation antipsychotics may compound the risk of developing the metabolic syndrome and CVD. In addition, smoking, poor diet, reduced physical activity and alcohol or drug abuse are prevalent in people with schizophrenia and contribute to the overall CVD risk. Management and minimization of metabolic risk factors are pertinent when providing optimal care to patients with schizophrenia. This review recommends a framework for the assessment, monitoring and management of patients with schizophrenia in the UK clinical setting.
Birmingham Heartlands Hospital, Birmingham, UK. anthony.barnett@heartofengland.nhs.uk
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AH
Barnett
P
P
Mackin
I
I
Chaudhry
A
A
Farooqi
R
R
Gadsby
A
A
Heald
J
J
Hill
H
H
Millar
R
R
Peveler
A
A
Rees
V
V
Singh
D
D
Taylor
J
J
Vora
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PB
Jones
D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000139:chemically induced* / Q000517:prevention & control*; D003924:Diabetes Mellitus, Type 2 / Q000139:chemically induced / Q000517:prevention & control; D005260:Female; D006801:Humans; D006949:Hyperlipidemias / Q000139:chemically induced / Q000517:prevention & control; D006973:Hypertension / Q000139:chemically induced / Q000517:prevention & control; D008297:Male; D024821:Metabolic Syndrome / Q000139:chemically induced* / Q000209:etiology / Q000517:prevention & control*; D009765:Obesity / Q000139:chemically induced / Q000517:prevention & control; D017410:Practice Guidelines as Topic; D012307:Risk Factors; D012559:Schizophrenia / Q000150:complications / Q000188:drug therapy*; D006113:United Kingdom; D015430:Weight Gain / Q000187:drug effects
D014150:Antipsychotic Agents