title: [Psychosis, cardiovascular risk and associated mortality: are we on the right track?].
abstract: Patients with psychotic disorders have a higher risk of early mortality. In addition to unnatural causes (accidents, suicide), death due to cardiovascular (CV) reasons is two to four times more prevalent in these patients than in the general population. This non-systematic review of MEDLINE aims to clarify the role of all the determining factors are involved. Psychotic disorders are related to unhealthy life habits such as smoking, poor diet and physical inactivity. Neuroleptic drugs have also been studied as triggers of obesity and metabolic syndrome. Therefore, psychotic patients seem predisposed to suffer from several of the «classic» CV risk factors. It is not surprising that their scores on the CV risk scales (Framingham, SCORE) are higher than the general population. We also found publications that showed poorer management of primary and secondary prevention of CV disease. In addition, some biochemical factors (plasma levels of cortisol, ACTH, homocysteine, PCR) may indicate a vulnerability in psychosis per se, as well as the findings on hyperglycemia and insulin resistance in psychotic "drug naive" patients. These "non-classical" factors could alter the validity of CV risk scales designed for the general population. Furthermore, antipsychotic drugs could control intrinsic factors of psychosis (they have shown to reduce global mortality), and their role in CV mortality is not clear.
authors.affiliation: Médico de familia, EAP Besòs, Barcelona, España. Electronic address: doctor.miguel.castillo@gmail.com.
authors.forename: Miguel
authors.initials: M
authors.lastname: Castillo Sánchez
authors.affiliation: Médico de familia, EAP La Marina, Barcelona, España.
authors.forename: Mireia
authors.initials: M
authors.lastname: Fàbregas Escurriola
authors.affiliation: Psiquiatra, INAD-PSMar, GREEN-FIMIM, Barcelona, España.
authors.forename: Daniel
authors.initials: D
authors.lastname: Bergè Baquero
authors.affiliation: Endocrinólogo, PSMar, Barcelona, España.
authors.forename: Albert
authors.initials: A
authors.lastname: Goday Arno
authors.affiliation: Farmacólogo clínico, ICS, Barcelona, España.
authors.forename: Joan Antoni
authors.initials: JA
authors.lastname: Vallès Callol
mesh_terms: D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology / Q000401:mortality*; D004032:Diet; D006801:Humans; D008019:Life Style; D009043:Motor Activity / Q000502:physiology; D015995:Prevalence; D011618:Psychotic Disorders / Q000150:complications / Q000188:drug therapy / Q000401:mortality*; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology
chemical_list: D014150:Antipsychotic Agents
keywords: Antipsychotic agents; Cardiovascular disease; Enfermedad cardiovascular; Esquizofrenia y otros trastornos con características psicóticas; Estilo de vida; Factor de riesgo; Fármacos antipsicóticos; Life style; Metabolic syndrome X; Mortalidad; Mortality; Risk factor; Schizophrenia and disorders with psychotic features; Síndrome metabólico