Data show ‘robust’ relationship between schizophrenia, heart disease in women
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Key takeaways:
- Schizophrenia is associated with increased risk for heart disease in both sexes, with greater risk seen in women.
- Researchers said it is important to promote physical activity for women at CV risk.
Epidemiological data show women with schizophrenia are 63% more likely to develop CVD during 3.5 years of follow-up compared with those without the condition, with a greater risk observed for women with obesity.
“The prevention of CVD in women is of paramount important in current clinical practice,” Hidehiro Kaneko, MD, PhD, associate professor at the University of Tokyo, told Healio. “Based on the results of our study, we should recognize that the presence of schizophrenia in women would pose a greater risk for the development of CVD than it does for men.”
In a retrospective study of insurance claims data, Kaneko and colleagues analyzed data from 4,124,508 adults without baseline CVD or renal replacement therapy. The median age of patients was 44 years and 57% were men.
The primary outcome was a composite of CV events including MI, angina, stroke, HF, atrial fibrillation and pulmonary thromboembolism.
Within the cohort, 0.64% of men and 0.92% of women had schizophrenia. For both sexes, the prevalence of obesity, hypertension, diabetes, dyslipidemia and physical inactivity was more among those with schizophrenia vs. those without.
During a mean follow-up of 1,288 days, there were 119,827 CVD events in men, for an incidence rate of 141.1 per 10,000 person-years, and 62,331 CVD events in women, for an incidence rate of 112 per 10,000 person-years.
The HR for the composite CV endpoint for people with schizophrenia was 1.63 for women (95% CI, 1.52-1.74) and 1.42 for men (95% CI, 1.33-1.52; P for interaction = .0049).
In analyses stratified by CVD type, the HRs for MI among people with schizophrenia were 1.31 for women (95% CI, 0.84-2.04) and 1.04 for men (95% CI, 0.78-1.4); HRs for angina were 1.53 for women (95% CI, 1.38-1.7) and 1.33 for men (95% CI, 1.2-1.48); HRs for stroke were 1.42 for women (95% CI, 1.21-1.66) and 1.49 for men (95% CI, 1.29-1.73); HRs for HF for 1.8 for women (95% CI, 1.64-1.97) and 1.42 for men (95% CI, 1.29-1.56); HRs for AF were 1.44 for women (95% CI, 1.09-1.9) and 1.02 for men (95% CI, 0.82-1.27); and HRs for pulmonary embolism were 2.78 for women (95% CI, 1.89-4.08) and 1.93 for men (95% CI, 1.23-3.04).
In obese people, there was a stronger relationship between schizophrenia and incident CVD in women than in men, according to researchers.
The researchers noted that the findings suggest health care providers should incorporate routine screening and treatment of schizophrenia into standard clinical practice for all individuals.
“We found a robust relationship between schizophrenia and a subsequent risk of developing CVD, and this relationship is more pronounced in women,” the researchers wrote. “Our results suggest a need for greater support for individuals (particularly women) with schizophrenia. Psychiatrists, cardiologists, and general physicians should share the
findings of this study and apply them to CVD prevention, especially in women.”
For more information:
Hidehiro Kaneko, MD, PhD, can be reached at kanekohidehiro@gmail.com; X (Twitter): @kanekohidehiro.
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