Schizophrenia and increased risks of cardiovascular disease
Schizophrenia and increased risks of cardiovascular disease
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DOI：
10.1016/j.ahj.2005.02.007
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发表时间：
2005-12-01
影响因子：
4.8
通讯作者：
Casey, DE
中科院分区：
文献类型：
--
作者：
Hennekens, CH;Hennekens, AR;Casey, DE
目的探讨主要致死因素对精神分裂症患者过早死亡的绝对和相对影响。资料来源：回顾已发表的关于一般人群和精神分裂症患者死亡原因的文章。资料选择：我们选择发表总死亡率和特定死因死亡率的文章。资料提炼：回顾死亡原因及其危险因素。资料综合精神分裂症患者的平均预期寿命为76岁(男性72岁，女性80岁)，而相应的数字为61岁(男性57岁，女性65岁)。因此，与普通人群相比，精神分裂症患者的预期寿命大约减少了20%。尽管精神分裂症患者自杀的可能性是普通人群的10到20倍，但超过三分之二的精神分裂症患者死于冠心病(CHD)，而普通人群中的这一比例约为一半。吸烟、肥胖导致血脂异常、胰岛素抵抗和糖尿病、高血压是导致这种超额死亡的主要危险因素。结论CHID是导致精神分裂症患者超额死亡的主要原因，主要由其不良危险因素所致。由于精神分裂症患者获得医疗保健的机会较少，消耗的医疗保健较少，而且对他们的治疗方案的依从性较差，因此选择不会进一步对他们的冠心病风险因素产生不利影响的抗精神病药物方案，是精神分裂症患者面临的主要临床和公共卫生挑战。
Objective The aim of the study is to review the absolute and relative impacts of the major causes for premature mortality among patients with schizophrenia.Data sources We reviewed published articles on causes of mortality in the general population as well as among patients with schizophrenia.Study selection We selected articles which published total and cause-specific mortality rates.Data extraction We reviewed the causes of mortality and their risk factors.Data synthesis The average life expectancy of the general population is 76 years (72 years in men, 80 years in women), whereas the corresponding figure is 61 years (57 years in men, 65 years in women) among patients with schizophrenia. Thus, patients with schizophrenia have approximately a 20% reduced life expectancy compared with the general population. Although patients with schizophrenia are 10 to 20 times more likely than,the general population to commit suicide, more than two thirds of patients with schizophrenia, compared with approximately one-half in the general population, die of coronary heart disease (CHD). The chief risk factors for this excess risk of death are cigarette smoking, obesity leading to dyslipidemia, insulin resistance and diabetes, and hypertension.Conclusions The chief cause of excess premature mortality among patients with schizophrenia is CHID, caused mainly by their adverse risk factor profile. Because patients with schizophrenia have less access to medical care, consume less medical care, and are less compliant with their regimens, the choice of antipsychotic drug regimens that do not further adversely affect their risk factor for CHD is a major clinical and public health challenge among patients with schizophrenia.