Death by heart attack more likely in patients with schizophrenia

The head and the heart may be more closely related than previously thought.

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According to a new study from the Centre for Addiction and Mental Health (CAMH) and the Institute for Clinical Evaluative Sciences (ICES), people with schizophrenia are at a higher risk for heart attack than those not saddled with the condition. Researchers found that patients with schizophrenia, on average, live 20 years less than the general population — a result spurred in part by a variety of factors associated with schizophrenic individuals, such as smoking, heightened diabetes rates and metabolic problems associated with certain antipsychotic medications.

The team found that the above influences tend to worsen in a schizophrenic patient following a cardiac episode as the person is less likely to alter their lifestyle by means or exercise or diet to counteract the problem.  

"When we looked at the data, we found that people with schizophrenia were 56 per cent more likely to die after discharge from [a] hospital following a heart attack than those who did not have schizophrenia," says Paul Kurdyak, MD, Division of General and Health Systems Psychiatry at CAMH, Adjunct Scientist at ICES, said in a press release. "We also found that patients with schizophrenia, despite the increase in mortality risk after a heart attack, were half as likely to receive life-saving cardiac procedures and care from cardiologists than those without schizophrenia."

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More specifically, Kurdyak and his colleagues found that following discharge from the hospital, schizophrenia-inflicted patients were less likely to visit a cardiologist within 30 days; 50 percent were less likely to pursue a cardiac procedure in the first place. As such, it’s important for physicians and other medical professionals to be especially wary of patient mental histories and act accordingly, toward prevention. Physicians should encourage patients with a history of schizophrenia to maintain balanced diets and exercise; doctors should also do their best to monitor these amendments.

"The numbers tell us that people with schizophrenia-- the ones who are at most risk to develop and subsequently die from heart attacks -- are not receiving adequate care," Kurdyak concluded. "The possible solutions are two-fold: Prevention is one. We need to support patients whom we know are at risk of developing medication-related metabolic issues by working with them to provide strategies to offset weight gain, such as healthy eating and physical activity. The other part is aftercare - the mental health care team, primary care providers, and the cardiac specialists need to work together to ensure that patients are seen again after a first incident of heart attack."


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