Characterizing Coronary Heart Disease Risk in Chronic Schizophrenia: High Prevalence of the Metabolic Syndrome

Objective: To determine the prevalence and characteristics of coronary heart disease (CHD) risk factors in patients with chronic schizophrenia or schizoaffective disorder. Method: We compared individual CHD risk factors and Framingham risk predictions in a group of 240 patients with a large national sample (Canadian Heart Health Survey) matched for age and sex. In addition, we compared rates of the metabolic syndrome (syndrome X) with recently published rates in the US adult population. Results: Compared with the reference population, Framingham 10-year risk of myocardial infarction was greater in the male patients (t(3091) = 4.35, P < 0.001) but not in the female patients. Prevalence rates of the metabolic syndrome in the patients (42.6% of men and 48.5% of women) were approximately 2 times published rates in the US adult population. Further, the syndrome appears to occur at a younger age than in the general population. Conclusions: These long-term patients have increased CHD risks best captured by the metabolic syndrome conceptualization coupled with a high rate of cigarette smoking. This characterization is consistent with increased cardiovascular morbidity and decreased life expectancy in both men and women. We underscore the importance of both screening for and treating potentially reversible CHD risk factors in schizophrenia patients. (Can J Psychiatry 2004;49:753-760)