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A four-year naturalistic prospective study of cardiometabolic disease in antipsychotic-treated patients

Published online by Cambridge University Press:  15 April 2020

P. Mackin ,
T. Waton ,
H.M. Watkinson  and
P. Gallagher
P. Mackin*
Affiliation:
Academic Psychiatry, Institute of Neuroscience, Newcastle General Hospital, Newcastle University, Westgate Road, Newcastle upon Tyne, NE4 6BE, United Kingdom
T. Waton
Affiliation:
Academic Psychiatry, Institute of Neuroscience, Newcastle General Hospital, Newcastle University, Westgate Road, Newcastle upon Tyne, NE4 6BE, United Kingdom
H.M. Watkinson
Affiliation:
Academic Psychiatry, Institute of Neuroscience, Newcastle General Hospital, Newcastle University, Westgate Road, Newcastle upon Tyne, NE4 6BE, United Kingdom
P. Gallagher
Affiliation:
Academic Psychiatry, Institute of Neuroscience, Newcastle General Hospital, Newcastle University, Westgate Road, Newcastle upon Tyne, NE4 6BE, United Kingdom
*
* Corresponding author. Tel.: +44 0 191 256 2319; fax: +44 0 191 256 3287. E-mail address:paul.mackin@ncl.ac.uk (P. Mackin).
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Abstract

The relationship between antipsychotic use and cardiovascular morbidity and mortality is controversial. There is a lack of long-term prospective studies investigating changes in cardiometabolic risk in patients treated with antipsychotic drugs. We report data from a 4-year prospective study. Patients (89) underwent detailed metabolic and cardiovascular risk assessment at 4-years which included anthropometric assessment, blood pressure, lipid profile, and an oral glucose tolerance test. We used the homeostatic model assessment to determine insulin resistance, and calculated 10-year cardiovascular risk scores. Mean age of subjects was 44.7 (±11.5) years, and 52% were male. The prevalence of type 2 diabetes was 8%, and 38.4% fulfilled diagnostic criteria for the metabolic syndrome. With the exception of increased central adiposity over the 4-year follow-up period (p < 0.001), other cardiometabolic parameters were generally unchanged. There was a high prevalence of dyslipidaemia, but only 16.9% were prescribed lipid-lowering treatment. Commencing lipid-lowering therapy was associated with a reduction in cardiovascular risk score (OR 7.9, 95% CI = 1.3 to 48.7; p = 0.02). Patients established on longer-term antipsychotic treatment show less dramatic metabolic changes than those occurring in the early stages of treatment, but have a high burden of cardiovascular risk. Lipid-lowering therapy is associated with a significant reduction in cardiovascular risk.

Keywords

AntipsychoticsObesityDiabetesCardiovascular riskMetabolic syndromeLipid-lowering therapy
Type
Original article
Information
European Psychiatry , Volume 27 , Issue 1 , January 2012 , pp. 50 - 55
Copyright
Copyright © Elsevier Masson SAS 2012

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