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Perspectives

Managing cardiovascular risk factors in people with serious mental illness: the tragedy of neglect

Roger Chen, Tim Lambert

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Abstract

People with serious mental illness are increasingly being recognised as being in a high-risk group with respect to premature morbidity and mortality due to cardiovascular disease and diabetes. A proactive approach to assessment and targeted screening of these patients for cardiovascular risk factors should be taken.

Key Points

  • People with schizophrenia and other psychotic disorders (serious mental illness) have a very high risk of developing early an untimely cardiovascular disease.
  • Physical health issues are traditionally neglected in this group of patients.
  • Use of antipsychotics is usually ‘blamed’ for the increase in cardiovascular disease and diabetes but is unlikely to be the main contributor.
  • Traditional cardiovascular risk factors, such as diabetes and obesity (due to poor diet and physical inactivity), dyslipidaemia and smoking, need to be addressed proactively and considered early within the management plan.
  • There are special considerations in the management of people with schizophrenia, such as poor adherence to medications and polypharmacy, which need to be addressed.

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