title: Cardiovascular risk factors among patients with schizophrenia, bipolar, depressive, anxiety, and personality disorders.
abstract: The evidence informing the management of cardiovascular risk in patients with psychiatric disorders is weak.
  
  
  
  This cohort study used data from all patients, aged≥30, registered in 140 primary care practices (n=524,952) in London to estimate the risk of developing diabetes, hypertension, hyperlipidemia, tobacco consumption, obesity, and physical inactivity, between 2005 and 2015, for patients with a previous diagnosis of schizophrenia, depression, anxiety, bipolar or personality disorder. The role of antidepressants, antipsychotics and social deprivation in these associations was also investigated. The age at detection of cardiovascular risk factor was compared between patients with and without psychiatric disorders. Variables, for exposures and outcomes, defined from general practitioners records, were analysed using multivariate regression.
  
  
  
  Patients with psychiatric disorders had an increased risk for cardiovascular risk factors, especially diabetes, with hazard ratios: 2.42 (2.20-2.67) to 1.31 (1.25-1.37), hyperlipidemia, with hazard ratios: 1.78 (1.60-1.97) to 1.25 (1.23-1.28), and obesity. Antidepressants, antipsychotics and social deprivation did not change these associations, except for smoking and physical inactivity. Antidepressants were associated with higher risk of diabetes, hypertension and hyperlipidemia. Antipsychotics were associated with a higher risk of diabetes. Antidepressants and antipsychotics were associated with lower risk of other risk factors. Patients with psychiatric conditions have later detection of cardiovascular risk factors. The interpretation of these results should acknowledge the lower rates of detection of risk factors in mentally ill patients.
  
  
  
  Cardiovascular risk factors require special clinical attention among patients with psychiatric disorders. Further research could study the effect of antidepressants and antipsychotics on cardiovascular risk factors.
authors.affiliation: The Westborough Road Health Centre, Westcliff-on-Sea, United Kingdom.
authors.forename: M
authors.initials: M
authors.lastname: Pérez-Piñar
authors.affiliation: Centre for Primary Care and Public Health, Queen Mary university of London, London, United Kingdom.
authors.forename: R
authors.initials: R
authors.lastname: Mathur
authors.affiliation: Institut Universitari d'Investigació en Atenció Primària Jordi Gol, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: Q
authors.initials: Q
authors.lastname: Foguet
authors.affiliation: Division of Health and Social Care Research, King's College London, London, United Kingdom.
authors.forename: S
authors.initials: S
authors.lastname: Ayis
authors.affiliation: Centre for Primary Care and Public Health, Queen Mary university of London, London, United Kingdom.
authors.forename: J
authors.initials: J
authors.lastname: Robson
authors.affiliation: The Westborough Road Health Centre, Westcliff-on-Sea, United Kingdom; Centre for Primary Care and Public Health, Queen Mary university of London, London, United Kingdom. Electronic address: l.garcia-morzon@qmul.ac.uk.
authors.forename: L
authors.initials: L
authors.lastname: Ayerbe
mesh_terms: D000328:Adult; D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000627:therapeutic use; D001008:Anxiety Disorders / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D001714:Bipolar Disorder / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000453:epidemiology*; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D006801:Humans; D008131:London; D008297:Male; D008875:Middle Aged; D010554:Personality Disorders / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D012307:Risk Factors; D012559:Schizophrenia / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*
chemical_list: D000928:Antidepressive Agents; D014150:Antipsychotic Agents
keywords: Antidepressive agents; Antipsychotic agents; Cardiovascular diseases; Cohort studies; Schizophrenia; Socioeconomic factors