How depression may increase heart disease risk

People with severe mental illness (SMI), including schizophrenia, bipolar disorder and major depression, have a 53 per cent higher risk for having cardiovascular disease than individuals without mental illness, says a large study of more than 3.2 million people.

The researchers also identified some important factors which increase risk for cardiovascular disease, including antipsychotic use and higher body mass index.

The results suggest that clinicians, where possible, should choose antipsychotics with lower side effects related to weight gain, high blood pressure and glucose abnormalities.

Published online in the journal World Psychiatry, these findings highlight the importance of regularly screening severe mental illness patients for cardiovascular risk and also point towards a number of potentially modifiable risk factors.

"People with SMI (severe mental illness) die much earlier than those without these disorders, yet the majority of these premature deaths may be preventable with care that prioritises lifestyle changes, such as exercise, better nutrition and stopping smoking, along with cautious prescribing of antipsychotics," said Brendon Stubbs from King's College London.

This new study of SMI and cardiovascular disease, led by King's College London, involved over 3.2 million patients and more than 113 million people from the general population. The researchers examined 92 studies across four continents and 16 different countries.

The results showed that 10 per cent of people with SMI had cardiovascular disease, with rates slightly higher in schizophrenia (11.8 per cent) and depression (11.7 per cent) than bipolar disorder (8.4 per cent). Their risk of dying from the disease was also 85 per cent higher than people of a similar age in the general population, the study said.