Several studies from different countries demonstrate that cardiovascular mortality is the main cause of death for schizophrenia patients as well as for the population although patients with schizophrenia have a doubled cardiovascular mortality risk. The general population of Sweden has during recent years experienced remarkable declines in mortality from cardiovascular disease resulting in increased overall life expectancy. It is unclear whether patients with schizophrenia have experienced these benefits.

Standardized mortality ratios (SMR) for schizophrenia patients in Sweden during 1970 through 2003 were analyzed, using data from national registers on diagnosis and causes of death. Secular trends for SMR were calculated in Poisson regression models.

SMR was for schizophrenia patients for all causes of death 2.33 for men and 2.35 for women, cardiovascular death 2.08 for men and 2.15 for women, coronary heart disease 1.91 for men and 2.06 for women, and for myocardial infarction 1.75 for men and 1.86 for women. Age-standardized mortality ratios for schizophrenia patients increased significantly (p<0.001) for both men and women for all causes of death, cardiovascular disease, coronary heart disease and acute myocardial infarction. Among schizophrenia patients, there were 3,410 excess deaths from cardiovascular causes.

The substantial improvements in recent years in mortality from cardiovascular disorders in the general population were not observed among patients with schizophrenia. For the medical care system and for psychiatry the increasing differences in mortality from cardiovascular disease between the general population and patients with schizophrenia are a major clinical and public health concern.