risk management

CVD Risk Increased in Patients With Mental Illness

Individuals with serious mental illness (SMI) are at an increased risk of cardiovascular disease (CVD) when compared to individuals without SMI, and are at an increased risk at younger ages, according to results of a recent study.

Participants included were adults aged 18 to 75 years who had a primary care visit between January 2016 to September 2018. Diagnosis codes were utilized to group patients who had bipolar disorder, schizophrenia, or schizoaffective disorder into the SMI group. After adjusting for covariates, a total of 11,333 individuals with SMI and 579,924 individuals without SMI were included.

The 10-year cardiovascular risk was measured by atherosclerotic CVD scores of participants without CVD who were aged 40 to 75 years. The 30-year cardiovascular risk was measured by the Framingham risk scores of participants without CVD who were aged 18 to 59 years.

Results indicate that individuals with SMI had a significantly higher 10-year cardiovascular risk (mean 9.44%; 95% CI, 9.29%-9.60%) when compared with individuals without SMI (mean 7.99%; 95% CI, 7.97%-8.02%). The 30-year cardiovascular risk was also higher in those with SMI when compared to those without SMI (25% and 11%, respectively; P < .001).

Individuals with bipolar disorder had the highest 10-year cardiovascular risk, and individuals with schizoaffective disorder had the highest 30-year risk.  Elevated BMI and smoking were the individual risk factors that contributed most to increased risk among individuals with SMI.

Individuals with SMI also had higher rates of diagnosed diabetes (14% vs 7%, respectively) and high blood pressure (15% vs 13%) when compared to those without SMI.

“The significantly increased cardiovascular risk associated with SMI is evident even in young adults,” researchers concluded. “This suggests the importance of addressing uncontrolled major cardiovascular risk factors in those with SMI at as early an age as possible.”


—Leigh Precopio



Rossom RC, Hooker SA, O’Connor PJ, Crain AL, Speri-Hillen JM. Cardiovascular risk for patients with and without schizophrenia, schizoaffective disorder, or bipolar disorder. J Am Heart Assoc. Published online March 9, 2022. doi:10.1161/JAHA.121.021444