07/08. tbl. 98.árg. 2012

A study of risk factors for cardiovascular disease among schizophrenic patients using the rehabilitation mental health services at Kleppur

Rannsókn á áhættuþáttum hjarta- og æðasjúkdóma hjá geðklofasjúklingum á geðsviði Landspítala

Background: Studies have shown that schizophrenic patients die on average 15-20 years earlier than the normal population, and that increased prevalance of cardiovascular risk factors plays a crucial role  Schizophrenic patients are underdiagnosed and undertreated when it comes to diabetes, hypertension and dyslipidemia. The aim of this study was to investigate the prevalence of metabolic syndrome, obesity, hypertension, diabetes and dyslipidemia among schizophrenic patients in Iceland.

Methods: An observational study of 106 schizophrenic patients in Iceland during the period 2007-2009. The results were compared to age adjusted population based data.

Results: 106 patients participated, 86 men and 20 women. In all 57% were diagnosed with metabolic syndrome (p<0.0001) in comparison to 14.1% in the general population. In all 73% were smokers (21% in the general population) p<0.0001 and 23.6% had hypertension of which only 20%  were treated with anti-hypertensive medication. The average systolic blodpressure was 134.8 mmHg <0.001. In all 15.1% had a fasting glucose over 7 mmol/l but only 38% were previously diagnosed with diabetes. The average BMI was 29.7 kg/m² p=0.0007, 45.3% were obese (BMI >30 kg/m²). Only 32.1% had normal BMI, and 82.1% had waist circumference over the normal limits. 

Conclusion: The physical condition of Icelandic schizophrenic patients is poor and their risk for cardiovascular diseases is high. It is necessary to follow  their weight, blood pressure, blood glucose and lipids more closely It is imperative to educate and  enable the schizophrenic patient to live a healthier life.

Sveinsson O1,2, Thorleifsson K1, Aspelund Th3,4, Kolbeinsson H1

1Rehabilitation Mental Health Services, The National University Hospital of Iceland, 2Department of Neurology, Karolinska University Hospital, Stockholm, Sweden, 3Icelandic Heart Association, 4University of Iceland.1

Metabolic syndrome was diagnosed if three or more factors were present:
Waist circumference: men > 102 cm and women > 88 cm
Triglycerides: ≥  1,70 mmol/L
HDL cholesterol: men ≤ 1,0 mmol/l and women ≤ 1,3 mmol/l
Blood pressure ≥ 130/85mmHg
Fasting blood glucose  ≥ 6,1 mmol/l or medication for hyperglycemia

Table I. The National Cholesterol Education Program (NCEP) definintion of metabolic syndrome.

Measurements Average Scale
Systole 134,2 mmHg 100 – 199 mmHg
Diastole 84,1 mmHg 47 – 116 mmHg
Waist circumference 114,7 cm 70 - 142 cm
Height 178,4 cm 156 - 198,5 cm
Weight 94,4 kg 54,5 - 163,8 kg
Body mass index 29,6 kg/m²  17,6 - 43,3 kg/m²
Fasting glucose 5,8 mmol/L 3,9-19,6 mmol/L
Glycosylated hemoglobin 5,8 mmol/L 4,8-11,7 mmol/L
Total cholesterol 5,4 mmol/L 3,3-8,1 mmol/L
HDL cholesterol 1,2 mmol/L 0,5-2,3 mmol/L
Triglycerides* 1,8 mmol/L 0,2-7,1 mmol/L

Table II. Result of measurements. *Median value.

Figure 1. Shows the prevalence of metabolic syndrome for the normal population and schizophrenic patients in the United States and Iceland.

Þetta vefsvæði byggir á Eplica