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Serious mental illness linked to elevated stroke risk

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People diagnosed with a serious mental health condition may be at a significantly increased risk of heart disease and stroke at a younger age, according to new research.

The findings are published today in the Journal of the American Heart Association (JAMA).

Researchers in the US analysed health data for nearly 600,000 people who visited a primary care clinic in Minnesota and Wisconsin between January 2016 and September 2018.

Approximately 11,000 adults, two per cent, had been diagnosed with a serious mental illness: 70 per cent of whom were diagnosed with bipolar disorder, 18 per cent with schizoaffective disorder and 12 per cent with schizophrenia.

The individuals with a serious mental illness were more likely to be younger women, self-identify as Black race, Native American, Alaskan race or of multiple races; and be insured by Medicare or Medicaid than those not diagnosed with a serious mental illness.

The researchers used prediction models to assess cardiovascular risk factors and predict the likelihood of a stroke, heart attack or death.

The research revealed:

  • Adults with a serious mental illnesses had an estimated 10-year cardiovascular risk level of 9.5 per cent, compared to 8 per cent for adults without a mental condition.
  • The estimated 30-year risk of cardiovascular disease was significantly higher among those individuals with one of the three serious mental illnesses – 25 per cent compared to 11 per cent of people without a serious mental illness.
  • The increased risk of heart disease was evident even in young adults (ages 18-34) with a serious mental illness.

Smoking and BMI accounted for many of the risk factors associated with cardiovascular disease in the people with a serious mental health condition.

They were three times more likely to be current smokers, with 50 per cent meeting the criteria for obesity, compared to 36 per cent of those without a serious mental illness.

Study lead author Rebecca C. Rossom, M.D., M.S., a senior research investigator in behavioural health at the Center for Chronic Care Innovation at HealthPartners Institute in Minneapolis, Minnesota, said:

“Even at younger ages, people with serious mental illness had a higher risk of heart disease than their peers, which highlights the importance of addressing cardiovascular risk factors for these individuals as early as possible.

“Interventions to address heart disease risk for these individuals are maximally beneficial when initiated at younger ages.

“We encourage health care systems and clinicians to use the 30-year cardiovascular risk estimates for young adults with serious mental illness, as these may be used starting at age 18.

“Right now, estimates of 10-year heart disease risk are used most frequently, and they cannot be applied until people are at least 40 years old, which is too late to start addressing heart disease risk in people with serious mental illness.”

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