• Posted March 9, 2022

Heart Risks Double for People With Bipolar, Schizophrenia

People with serious mental illness have up to double the risk of heart disease, and should have their heart health monitored from a young age, a new study finds.

Specifically, those mental health issues are bipolar disorder, schizophrenia and schizoaffective disorder.

"Previous research has indicated that people diagnosed with a serious mental illness die 10-20 years earlier than the general population, and their leading cause of death is heart disease," said lead author Dr. Rebecca Rossom.

"Our study focused on the contribution of cardiovascular risk factors, such as blood pressure, cholesterol, blood sugar, body mass index and smoking status, to compare overall heart disease risk for people with and without serious mental illness," explained Rossom, a senior research investigator in behavioral health at the Center for Chronic Care Innovation at HealthPartners Institute in Minneapolis.

Earlier detection and treatment of major heart disease risk factors such as obesity, smoking, diabetes and high blood pressure in young adults with bipolar disorder, schizophrenia or schizoaffective disorder may reduce their future risk of heart disease, according to the researchers.

Bipolar disorder causes unusual shifts in mood, energy, activity levels, concentration and the ability to carry out day-to-day tasks, while schizophrenia can cause hallucinations, delusions or disorganized speech, according to the U.S. National Institute of Mental Health.

Schizoaffective disorder involves both a major mood disorder (manic or depressive) and schizophrenia.

In this study, the researchers assessed the 10-year and 30-year heart disease risk among nearly 600,000 adults, ages 18-75, who visited primary care clinics in Minnesota and Wisconsin between January 2016 and September 2018.

Nearly 2% of the adults had been diagnosed with a serious mental illness. Of these, 70% had bipolar disorder, 18% had schizoaffective disorder and 12% had schizophrenia.

Among adults with one of these mental illnesses, the estimated 10-year risk of heart disease was almost 10% and the 30-year risk of heart disease was 25%, compared with 8% and 11%, respectively, among those without a serious mental illness.

The increased risk of heart disease was evident even in young adults (ages 18-34) with a serious mental illness.

People with bipolar disorder had a higher 10-year heart disease risk than those with schizophrenia or schizoaffective disorder, while people with schizoaffective disorder had a higher 30-year heart disease risk than the other two groups.

Smoking and obesity were major factors in heart disease risk among adults with a serious mental illness. They were three times more likely to be current smokers (36%) and much more likely to be obese (50%) than those without serious mental illness (12% and 36%, respectively).

The researchers also found that adults with a serious mental illness had double the rate of diabetes compared to mentally healthy people, while 15% of adults with a serious mental illness had high blood pressure versus 13% of those without a serious mental illness.

The study was published March 9 in the Journal of the American Heart Association.

"Even at younger ages, people with serious mental illness had a higher risk of heart disease than their peers, which highlights the importance of addressing cardiovascular risk factors for these individuals as early as possible," Rossom said in a journal news release.

"We encourage health care systems and clinicians to use the 30-year cardiovascular risk estimates for young adults with serious mental illness, as these may be used starting at age 18," she said.

"Right now, estimates of 10-year heart disease risk are used most frequently, and they cannot be applied until people are at least 40 years old, which is too late to start addressing heart disease risk in people with serious mental illness," Rossom noted.

More information

The U.S. National Heart, Lung, and Blood Institute offers a guide to a healthy heart.

SOURCE: Journal of the American Heart Association, news release, March 9, 2022