title: Prevalence of cardiovascular risk factors among racial and ethnic minorities with schizophrenia spectrum and bipolar disorders: a critical literature review.
abstract: OBJECTIVE
  People with serious mental illness (SMI) die at least 11 years earlier than the general U.S. population, on average, due largely to cardiovascular disease (CVD). Disparities in CVD morbidity and mortality also occur among some U.S. racial and ethnic minorities. The combined effect of race/ethnicity and SMI on CVD-related risk factors, however, remains unclear. To address this gap, we conducted a critical literature review of studies assessing the prevalence of CVD risk factors (overweight/obesity, diabetes mellitus, metabolic syndrome, hypercholesterolemia, hypertension, cigarette smoking, and physical inactivity) among U.S. racial/ethnic groups with schizophrenia-spectrum and bipolar disorders.
  
  
  RESULTS
  We searched MEDLINE and PsycINFO for articles published between 1986 and 2013. The search ultimately yielded 40 articles. There was great variation in sampling, methodology, and study populations. Results were mixed, though there was some evidence for increased risk for obesity and diabetes mellitus among African Americans, and to a lesser degree for Hispanics, compared to non-Hispanic Whites. Sex emerged as an important possible effect modifier of risk, as women had higher CVD risk among all racial/ethnic subgroups where stratified analyses were reported.
  
  
  CONCLUSIONS
  Compared to general population estimates, there was some evidence for an additive risk for CVD risk factors among racial/ethnic minorities with SMI. Future studies should include longitudinal assessment, stratification by sex, subgroup analyses to clarify the mechanisms leading to potentially elevated risk, and the evaluation of culturally appropriate interventions to eliminate the extra burden of disease in this population.
authors.affiliation: Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA, USA. Electronic address: hcarliner@mail.harvard.edu.
authors.forename: Hannah
authors.initials: H
authors.lastname: Carliner
authors.affiliation: Office for Research on Disparities and Global Mental Health, National Institute of Mental Health/NIH, Bethesda, MD, USA.
authors.forename: Pamela Y
authors.initials: PY
authors.lastname: Collins
authors.affiliation: Department of Psychiatry, Columbia University, New York, NY, USA; New York State Center of Excellence for Cultural Competence, New York State Psychiatric Institute, New York, NY, USA; Columbia University School of Social Work, New York, NY, USA.
authors.forename: Leopoldo J
authors.initials: LJ
authors.lastname: Cabassa
authors.affiliation: Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York, NY, USA.
authors.forename: Ann
authors.initials: A
authors.lastname: McNallen
authors.affiliation: Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA.
authors.forename: Sarah S
authors.initials: SS
authors.lastname: Joestl
authors.affiliation: Department of Psychiatry, Columbia University, New York, NY, USA; New York State Center of Excellence for Cultural Competence, New York State Psychiatric Institute, New York, NY, USA; Hispanic Treatment Program, New York State Psychiatric Institute, New York, NY, USA.
authors.forename: Roberto
authors.initials: R
authors.lastname: Lewis-Fernández
mesh_terms: D001741:Black or African American / Q000523:psychology; D001714:Bipolar Disorder / Q000453:epidemiology / Q000208:ethnology; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000208:ethnology; D006630:Hispanic or Latino / Q000523:psychology; D006801:Humans; D008913:Minority Groups / Q000523:psychology*; D015995:Prevalence; D012307:Risk Factors; D012559:Schizophrenia / Q000453:epidemiology / Q000208:ethnology; D044465:White People / Q000523:psychology