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17-01-2011 | Mental health | Article

CHD risk ‘not increased in first-episode psychosis patients’



MedWire News: Patients with a first episode of psychosis do not have a significantly increased 10-year risk for developing coronary heart disease (CHD), US research shows.

Although previous studies have shown that patients with chronic schizophrenia are significantly more likely to develop cardiovascular disease than their peers without serious mental illness, studies of cardiovascular disease risk in patients with first-episode psychosis have produced inconsistent results, explain Vinod Srihari and colleagues from Yale University School of Medicine in New Haven, Connecticut.

To investigate further, the researchers studied data on 56 patients with first-episode psychosis, aged an average of 22.5 years, and 145 age-, gender-, and race-matched mentally healthy controls.

All of the participants underwent comprehensive sociodemographic and clinical assessments, and their 10-year risk for developing coronary heart disease (CHD) was calculated using a tool developed by the National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATP III).

The NCEP-ATP III tool uses age, gender, total cholesterol, high-density lipoprotein (HDL) cholesterol, smoking status, systolic blood pressure, and use of antihypertensive medications to estimate CHD risk. Patients with scores of less than 10%, 10-19%, or 20% or more are classified as being at low, moderate, or very high risk, respectively.

The researchers found that first-episode psychosis patients were more likely to be smokers and to have hypertension than controls, at 46% versus 36%, and 13.5% versus 10.5%, respectively.

However, these differences were not statistically significant. There were also no statistically significant differences between the groups regarding weight, body mass index, total or HDL cholesterol, fasting plasma glucose, and diabetes status.

According to NCEP-ATP III criteria, the 10-year mean risk for CHD in both the first-episode psychos patients and controls was very low, at 1% (range 0-5%) and 0% (range 0-9%), respectively - a nonsignificant difference.

Srihari and team conclude: "First-episode psychosis patients do not present with significantly higher cardiovascular risk than age- and race-matched controls."

They add: "The evidence of the markedly increased CHD risk in chronic (and even relatively early treated) samples makes a compelling case for risk reduction strategies [in first-episode psychosis patients], with a focus on smoking cessation and careful monitoring for other traditional risk factors, including hypertension."

MedWire ( is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2011

By Mark Cowen

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