Schizophrenia, Depression and Anxiety Patients 'Twice as Likely' to Have Heart Disease or Stroke

People with mental health disorders are twice as likely to suffer from heart disease or a stroke, due to psychiatric medications, unhealthy behaviours and issues accessing care.

Researchers at the Centre for Addiction and Mental Health in Toronto studied the link between cardiovascular risk and disease, mental health disorders and the use of psychiatric medication, presenting the findings at the Canadian Cardiovascular Congress.

"This population is at high risk, and it's even greater for people with multiple mental health issues," says Dr Katie Goldie, lead author of the study.

The research found that people who have had a mental health disorder at any point in their life were twice as likely to have had heart disease or have experienced a stroke.

Those who have not developed heart disease or had a stroke are more likely to be at a high long-term risk of developing cardiovascular disease, when compared to the general population.

In addition, people who used psychiatric medications were twice as likely to have heart disease and three times as likely to have had a stroke compared to those not taking these medications.

The study included people with schizophrenia, bipolar disorders, major depressive and anxiety disorders. Among the psychiatric drugs examined were antipsychotic, antidepressant, benzodiazepine and mood-stabilising medications.

Three main factors were identified in terms of those who accounted for increased risk.

It was found that those with mental health disorders often exhibit behavioural risk factors, including tobacco and alcohol use, poor diet and physical inactivity.

According to the researchers, 40% to 90% of people with mental illness use tobacco, compared to 20% of the general Canadian population.

Psychiatric medications can induce weight gain and impair the breakdown of fats and sugars by the body. This can lead to obesity, high cholesterol and diabetes.

"The medications themselves account for a lot of risk in this group," Goldie added.

A third issue is access to health care. Patients with mental health disorders may have difficulty communicating their health needs.

"Or they may not even seek care because of the symptoms of their disorder," said Goldie. "A separation between primary and mental health services can also challenge these patients' care. We need improved integration and collaboration."

The stigma associated with mental illness can even affect the care that health professionals provide, the researchers state. People with mental health disorders are less likely to receive risk-reducing drug therapies or undergo coronary procedures such as bypass surgery.

Healthcare providers can improve the cardiovascular health of their patients by being vigilant in conducting routine cardiovascular risk assessments, before and after initiating psychopharmacological treatment, in addition to offering health promotion interventions to target known cardiovascular risk factors.

Dr Brian Baker, of the Canadian charity Heart and Stroke Foundation, told Medical Xpress: "The prevention strategies are the same for people with mental health issues. That means eating a healthy diet, being physically active, being smoke-free, managing stress and limiting alcohol consumption."

"Making positive health behaviour changes is important to our physical health and to mental health too," he added.