S87. IDEAL CARDIOVASCULAR HEALTH IN RACIALLY AND ETHNICALLY DIVERSE PEOPLE WITH SERIOUS MENTAL ILLNESS

Abstract

BackgroundCardiovascular disease (CVD) is a primary contributor to premature death among people with serious mental illness (SMI). This study examined the prevalence and correlates of the American Heart Association (AHA) metric of ideal cardiovascular health (ICVH) in racially and ethnically diverse people with serious mental illness living in supportive housing.MethodsOur study used baseline data from an NIMH-funded trial testing the effectiveness of a peer-led healthy lifestyle intervention, for overweight/obese participants with SMI in three supportive housing agencies. A total of 314 participants were enrolled in the trial and included in these analyses. Five ICVH metrics (BMI, smoking, diet, physical activity, and blood pressure [BP]) were measured and summed to create a composite ICVH score. Correlates were informed by findings from systematic literature reviews examining ICVH in the general population and studies examining correlates of CVD in people with SMI. Hierarchal regression analysis was used to examine the associations of sample correlates with the composite ICVH score.ResultsThe mean age of participants was 48.7 and 57.3% were male. The most common lifetime mental health diagnoses were depression (75.2%), schizophrenia/schizoaffective disorder (56.7%), and bipolar disorder (46.5%). Approximately 38.5% of participants reported lifetime substance abuse/dependence. The majority (62.7%) were taking an antipsychotic medication. Lifetime physical health diagnoses were high cholesterol (36.3%), diabetes (32.5%), cardiovascular disease (17.2%), and cancer (4.5%). Participants walked on average 318.4 meters during the six-minute walking test (6MWT), a measure of cardiorespiratory fitness (CRF). The prevalence of smoking (64.7%) and obesity (64%) were high, while the prevalence of ideal physical activity (37.6%), healthy diet status (2.2%), and ideal BP (23.6%) were low. The mean ICVH composite score was 3.15 (range 0 – 8). After controlling for all covariates, women, racial/ethnic minorities, use of antipsychotic medications, lifetime cancer diagnosis, and poor CRF were significantly (p < .05) related to low ICVH scores.DiscussionIn our racially/ethnically diverse sample of people with SMI in supportive housing, the prevalence of ICVH was low. Our findings suggest that there are specific subgroups that may benefit from targeted screening and interventions to improve cardiovascular health. The association between CRF and ICVH scores highlights the importance of increasing physical activity and reducing sedentary behavior. The AHA ICVH metric can be a useful tool for tracking and improving the cardiovascular health of people with SMI.