Cardiovascular Mortality and Related Risk Factors among Persons with Schizophrenia: A Review of the Published Literature

Although persons with schizophrenia (PWS) are entitled to health care and medical preventive and curative treatments in accordance with the same standards as other persons, they suffer from excess mortality compared with the general population. The main cause of natural premature death of PWS is attributed to cardiovascular disorders (CVD). We reviewed the studies of PWS, their risk factors and CVD mortality. In every study, PWS have increased risk of CVD mortality. Additionally, most but not all of the studies found increased CVD behavioral risk factors (i.e., smoking, sedentary life style/less physical activity, increased body mass index (BMI)) in PWS. In order to promote better health care to this population, we propose general recommendations to service users and their families, general and mental health professionals and policy makers. Severe mental illness such as schizophrenia should be addressed as a “risk equivalent” for CVD. Awareness of this association should be implemented in routine psychiatric and general medicine practice as well as at national levels for policy makers. Cardiovascular morbidity and mortality should be referred to as a measure of quality of care. Better communication between different physicians and other health care providers, who treat PWS, should be encouraged. This can be accompanied with technological advances (i.e., unified electronic medical record). Understanding of suggested treatment and adherence to recommendations in PWS may be improved by if relatives and friends accompany the patient in medical settings.