Cardiovascular risk in patients with severe mental illness in Italy

Virginio Salvi, Andrea Aguglia, Francesco Barone-Adesi, Davide Bianchi, Chiara Donfrancesco, Filippo Dragogna, Luigi Palmieri, Gianluca Serafini, Mario Amore, Claudio Mencacci

Research output: Contribution to journalArticlepeer-review


BACKGROUND: Patients with severe mental illness (SMI), such as schizophrenia or bipolar disorders, are more frequently affected by metabolic syndrome and cardiovascular (CV) diseases than the general population, with a significant reduction in life expectancy. Beyond metabolic syndrome, quantifying the risk of CV morbidity in the long-term may help clinicians to put in place preventive strategies. In this study, we assessed 10-year CV risk in patients with SMI and healthy individuals using an algorithm validated on the Italian general population. METHODS: Patients aged 35-69 years diagnosed with SMI were consecutively recruited from psychiatric acute care units. Single CV risk factors were assessed, and 10-year CV risk calculated by means of the CUORE Project 10-year CV risk algorithm, based on the combination of the following risk factors: age, systolic blood pressure, total and high-density lipoprotein cholesterol, diabetes, smoking habit, and hypertensive treatment. Patients' data were compared with those from the general population. The 10-year CV risk was log-transformed, and multivariable linear regression was used to estimate mean ratios, adjusting for age, and education. RESULTS: Three hundred patients and 3,052 controls were included in the analysis. Among men, the 10-year CV risk score was very similar between patients with SMI and the general population (mean ratio [MR]: 1.02; 95%CI 0.77-1.37), whereas a 39% increase in 10-year CV risk was observed in women with SMI compared to the general population (MR: 1.39; 95%CI 1.16-1.66). CONCLUSIONS: In our study, women with SMI were consistently more at risk than the general population counterpart, even at younger age.

Original languageEnglish
Pages (from-to)e96
JournalEuropean psychiatry : the journal of the Association of European Psychiatrists
Issue number1
Publication statusPublished - Oct 26 2020


  • Bipolar disorder
  • cardiovascular risk
  • schizophrenia
  • severe mental illness

ASJC Scopus subject areas

  • Psychiatry and Mental health


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