Cardiovascular and metabolic risk in outpatients with schizophrenia treated with antipsychotics: Results of the CLAMORS Study

被引:160
作者
Bobes, Julio [1 ]
Arango, Celso
Aranda, Pedro
Carmena, Rafael
Garcia-Garcia, Margarida
Rejas, Javier
机构
[1] Univ Oviedo, Med Dept, Psychiat Area, E-33006 Oviedo, Spain
[2] Hosp Gen Univ Gregorio Maranon, Dept Psychiat, Madrid, Spain
[3] Carlos Haya Hosp, Hypertens Unit, Malaga, Spain
[4] Valencia Univ Clin Hosp, Endocrinol Dept, Valencia, Spain
[5] Biometr CRO, Project Management Dept, Barcelona, Spain
[6] Pfizer Espana, Hlth Outcomes Res Dept, Med Unit, Madrid, Spain
关键词
cardiovascular risk; metabolic syndrome; schizophrenic disorders; outpatients; antipsychotic treatment; mental status;
D O I
10.1016/j.schres.2006.09.025
中图分类号
R749 [精神病学];
学科分类号
100205 ;
摘要
Aim: To assess the prevalence of Coronary Heart Disease (CHD) and Metabolic Syndrome (MS) in patients treated with antipsychotics. Methods: Retrospective, cross-sectional, multicenter study in which 117 Spanish psychiatrists (the CLAMORS Study Collaborative Group) recruited consecutive outpatients meeting DSM-IV criteria for Schizophrenia, Schizophreniform or Schizoaffective Disorder, receiving antipsychotic treatment for at least 12 weeks. CHD risk was assessed by SCORE (10-year CV death) and Framingham (10-year all CHD events) function. MS was defined by at least 3 of the following components: waist circumference > 102 (men)/> 88 (women) cm; triglycerides >= 150 mg/dl; HDL-cholesterol < 40 mg/dl (men)/< 50 mg/dl (women); blood pressure >= 130/85; fasting glucose >= 110 mg/dl. Results: 1452 evaluable patients (863 men, 60.9%), aged 40.7 +/- 12.2 years (mean +/- SD) were included. MS was present in 24.6% [23.6% (men), 27.2% (women); p=0.130)]. The overall 10-year risks were 0.9 +/- 1.9 (SCORE) and 7.2 +/- 7.6 (Framingham). 8% (95%CI: 6.5-9.5) and 22.1% (95%CI: 20.0-24.3) of patients showed a high/very high risk according to SCORE (>= 3%) and Framingham (>= 10%) function. Abdominal obesity and low HDL-cholesterol were more prevalent in women: 54.5% (95%CI: 50.2-58.9) versus 34.3% (95%CI: 31.0-37.7), and 46.1% (95%CI: 41.4) versus 28.5 (95%CI: 50.8), p < 0.001 in both cases. Hypertension and hypertriglyceridemia were more prevalent in men: 59.0% (95%CI: 55.7-62.3) versus 46.0% (95%CI: 41.8-50.2), and 40.7% (95%CI: 37.2-44.2) versus 32.4 (95%CI: 28.3-36.5), p < 0.01 in both cases. Conclusions: CHD risk and MS prevalences among patients with schizophrenia treated with antipsychotics were in the same range as the Spanish general population 10 to 15 years older. (c) 2006 Elsevier B.V. All rights reserved.
引用
收藏
页码:162 / 173
页数:12
相关论文
共 71 条
[1]   Prevalence of metabolic syndrome in the Spanish working population:: MESYAS registry [J].
Alegría, E ;
Cordero, A ;
Laclaustra, M ;
Grima, A ;
León, M ;
Casasnovas, JA ;
Luengo, E ;
del Río, A ;
Ferreira, I .
REVISTA ESPANOLA DE CARDIOLOGIA, 2005, 58 (07) :797-806
[2]   The distribution of body mass index among individuals with and without schizophrenia [J].
Allison, DB ;
Fontaine, KR ;
Heo, M ;
Mentore, JL ;
Cappelleri, JC ;
Chandler, LP ;
Weiden, PJ ;
Cheskin, LJ .
JOURNAL OF CLINICAL PSYCHIATRY, 1999, 60 (04) :215-220
[4]  
[Anonymous], AM PSYCH ASS ANN M S
[5]  
[Anonymous], 1988, VITAL HLTH STAT 1, V1 32, P1
[6]   Tables of coronary risk evaluation adapted to the Spanish population:: the DORICA study [J].
Aranceta, J ;
Rodrigo, CP ;
Sala, MF ;
Mantilla, T ;
Majem, LS ;
Moreno, B ;
Monereo, S ;
Millán, J .
MEDICINA CLINICA, 2004, 123 (18) :686-691
[7]   Prevalence of obesity in Spain:: Results of the SEEDO 2000 study [J].
Aranceta, J ;
Rodrigo, CP ;
Majem, LS ;
Barba, LR ;
Izquierdo, JQ ;
Vioque, J ;
Marí, JT ;
Verdú, JM ;
González, JL ;
Tojo, R ;
Sala, MF .
MEDICINA CLINICA, 2003, 120 (16) :608-612
[8]  
Ascaso JF, 2004, AV DIABETOL, V20, P23
[9]   Mortality among homeless people with schizophrenia in Sydney, Australia: a 10-year follow-up [J].
Babidge, NC ;
Buhrich, N ;
Butler, T .
ACTA PSYCHIATRICA SCANDINAVICA, 2001, 103 (02) :105-110
[10]   The prevalence of the metabolic syndrome in patients with schizoaffective disorder - bipolar subtype [J].
Basu, R ;
Brar, JS ;
Chengappa, KNR ;
John, V ;
Parepally, H ;
Gershon, S ;
Schlicht, P ;
Kupfer, DJ .
BIPOLAR DISORDERS, 2004, 6 (04) :314-318