Prevalence of Major Cardiovascular Disease Events Among People Diagnosed With Schizophrenia Who Have Sleep Disturbance, Sedentary Behavior, or Muscular Weakness.

Alexandra Berry,Alison R Yung,Darren M Ashcroft,Richard J Drake,Roger T Webb,Joseph Firth,Matthew J Carr

doi:10.1093/schizbullopen/sgaa069

Abstract

ObjectiveTo estimate prevalence of major cardiovascular events among people with schizophrenia who had experience of sleep disturbance, sedentary behavior or muscular weakness, and assess evidence for raised prevalence in these individuals compared to people with schizophrenia without these characteristics. MethodsUK Biobank data on individuals diagnosed with schizophrenia (n = 1544) were used to examine the prevalence of major cardiovascular events, specifically myocardial infarction, stroke, heart failure and cardiovascular death, among participants with candidate risk factors. Generalized linear models were fitted to estimate prevalence ratios (PRs) for major cardiovascular events among participants with self-reported sleep disturbance, self-reported sedentary behavior, and muscular weakness measured using a handgrip dynamometer. These ratios were adjusted for QRISK3 score—a validated cardiovascular risk prediction algorithm for the UK population. ResultsPrevalence of major cardiovascular events was significantly higher among participants with daytime sleepiness, independent of QRISK3 score, and snoring, a proxy for sleep-disordered breathing (adjusted PR 1.26; 95% CI 1.03, 1.55, P = .03). Prevalence was also independently higher among participants with low muscular strength (adjusted PR1.36; 95% CI 1.05, 1.75, P = .02). The adjusted prevalence ratios among participants with short or prolonged sleep duration, insomnia, or sedentary behavior did not indicate independently raised prevalence among these groups. ConclusionPrevalence of major cardiovascular events among people with schizophrenia was higher in participants with muscular weakness and sleep disturbance evidenced by daytime sleepiness. Further research is required to determine how these factors can be routinely identified and addressed in the clinical management of cardiovascular risk among patients with schizophrenia.

Highlights

People diagnosed with a severe mental illness (SMI), such as schizophrenia, have a shorter lifespan than the general population by 10 to 20 years.[1]
We investigated whether prevalence of major cardiovascular events was raised among participants with schizophrenia who had sleep disturbance, sedentary behavior, and muscular weakness, independent of other known cardiovascular disease (CVD) risk factors
Our findings indicate that people with schizophrenia with self-reported daytime sleepiness have a raised prevalence of major cardiovascular events, independent of other known risk factors; ie, those within the QRISK3 algorithm[16] and snoring, which we used as a marker for sleep-disordered breathing

Summary

Introduction

People diagnosed with a severe mental illness (SMI), such as schizophrenia, have a shorter lifespan than the general population by 10 to 20 years.[1]. The updated QRISK3 calculator is the tool of preference for clinical use in the United Kingdom[15] and includes SMI diagnosis and second-generation antipsychotic medication usage.[16]

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Discussion

Conclusion