J Korean Med Assoc.  2024 Feb;67(2):115-123. 10.5124/jkma.2024.67.2.115.

Management of cardiovascular disease in patients with schizophrenia

• Baek JH

• KMID: 2552010
• DOI: http://doi.org/10.5124/jkma.2024.67.2.115

Abstract

Background
Individuals with schizophrenia experience premature mortality by approximately 15 to 20 years compared to the general population. The most common cause of death in schizophrenia is cardiovascular disorder, yet cardiovascular disease-related conditions are often neglected in the treatment of schizophrenia.
Current Concepts
The overall incidence rate of cardiovascular disorders in patients with schizophrenia is about 10%. Diverse risk factors likely contribute to the association, with increased risk of metabolic syndrome, unhealthy lifestyle behaviors like smoking and a sedentary lifestyle, and an unhealthy diet playing a prominent role. While the effects of certain psychotropic medications, particularly atypical antipsychotics, may contribute to the presence of metabolic syndrome, their ability to reduce the psychiatric symptom burden reduces mortality. Shared pathophysiological mechanisms, including genetic, psychological, and inflammatory factors, have also been suggested. In particular, increased inflammation directly associated with disease-related brain activity may further impact the cardiovascular risk.
Discussion and Conclusion
Regular monitoring of metabolic syndrome, with psychoeducation for patients and their caregivers, is crucial to promote optimal cardiovascular health. Implementation of active psychosocial interventions targeted at behavior change is necessary. In addition, education to reduce stigma among medical professionals is warranted to improve communication between patients and medical professionals.

Keyword

Schizophrenia; Cardiovascular diseases; Risk factors; Mortality; 조현병; 심혈관질환; 위험인자; 사망률