Presentation (CTI)

OBJECTIVES: This study addresses the question of whether schizophrenia is associated with an increased risk of cardiovascular disease (CVD) by adjusting for metabolic syndrome-related conditions.
METHODS: This retrospective cohort study analyzed 12,527 patients aged 18 or older with schizophrenia from 1,209 general practices between 2005 and 2023 from the IQVIA Disease Analyzer database. Patients were matched 1:5 with individuals without schizophrenia based on sex, age, index year, consultation frequency and chronic conditions. CVD incidence was assessed using Kaplan-Meier curves and hazard ratios (HRs) were calculated using univariable Cox regression analysis.
RESULTS: Patients with schizophrenia had a significantly higher 10-year incidence of heart failure (8.3%) compared to patients without the disease (6.5%), with an overall HR of 1.33 (CI: 1.20-1.48). This association was significant among both women (9.4% vs. 7.4%, HR: 1.38, CI: 1.21-1.58) and men (HR: 1.28, CI: 1.09-1.50). The strongest association was observed in women aged 41-50 (HR: 3.34, CI: 2.11-5.31), followed by women aged 61-70 (HR: 1.88, CI: 1.45-2.44) and men aged 51-60 (HR: 1.81, CI: 1.34-2.45). In contrast, atrial fibrillation and flutter were less common in the schizophrenia cohort (4.5%) than in the non-schizophrenia cohort (5.8%), with an HR of 0.77 (CI: 0.67-0.89). No significant sex- or age-specific differences were observed for this outcome.
CONCLUSIONS: This study highlights significant differences in the 10-year incidence of cardiovascular diseases between individuals with and without schizophrenia. While patients with schizophrenia appear less likely to be diagnosed with milder or asymptomatic CVDs, they are at increased risk for severe outcomes. These findings underscore the need for sex-specific and symptom-sensitive public health strategies to improve early detection and prevention of cardiovascular diseases in patients with schizophrenia.