Risk of Cardiovascular Disease and Sudden Death in Schizophrenia

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Patients with schizophrenia are at higher risk for medical illnesses than people in the general population. Electrocardiographic and metabolic abnormalities that occur in patients with schizophrenia who are treated with antipsychotic medications have raised concerns about the safety of these medications. Concerns are amplified by the increased risk of atherosclerosis and sudden cardiac death in patients with schizophrenia regardless of the effect of antipsychotic agents. Because the modifiable risk factors for coronary atherosclerosis and sudden death are so prevalent within the schizophrenic population, it is important for clinicians treating patients with schizophrenia to know what these risks are and understand how they can contribute to increased mortality in these patients. The increased risk of atherosclerosis and sudden death in the schizophrenic population highlights a need for preventive services, which is further underscored by the numerous system- and patient-related barriers to preventive treatment. Clinicians must not only be aware of the modifiable risk factors, but they must also learn to manage the obstacles to prevention in conjunction with other health care specialists.

J Clin Psychiatry 2002;63(suppl 9):5-11