Cardiovascular disease risk factors in patients with severe mental illnesses admitted at Mathari National Teaching and Referral Hospital.

Abstract

Background Early cardiovascular mortality has been observed in people with severe mental illness (SMI) when compared to matched counterparts in the general population. A high cardiovascular mortality risk has been found in those with SMI. The risk factors driving this mortality arise from psychotropics related cardiometabolic effects, traditional cardiovascular risk factors (CVRFs) and from direct effects of the mental illness on the autonomic nervous system (ANS), neuroendocrine system and behaviour. Objectives To determine the prevalence of various CVRFs, the cardiovascular risk level and describe the correlation between age, behavior and clinical characteristics with metabolic syndrome among patients with SMI admitted at Mathari National Teaching and Referral Hospital (MNTRH). Methodology This was a descriptive cross-sectional study done at MNTRH. Consecutive sampling technique was used. The participants were interviewed, examined and blood was drawn for lipid profile and FBS. CVRFs: hypertension (HTN), hyperglycemia, dyslipidemia, smoking, risky alcohol use, increased BMI, abdominal obesity, inadequate physical activity and metabolic syndrome (MetS) were assessed. Data was analysed using SPSS version 23.0. Continuous variables were expressed as means ± Standard deviation and categorical variables as percentages. Univariate analysis was used to determine any relationship between age, behavioral and clinical characteristics of participants with Metabolic syndrome in SMI. Results We recruited 209 participants of whom 204 had complete data. The mean age was 37.73 ±8.9 years. Prevalence of CVRFs was as follows: dyslipidemia 60.3%, smoking 52.2%, risky alcohol use 42.6%, increased BMI 38.8%, abdominal obesity 37.3%, metabolic syndrome 27.5%, hyperglycemia 24%, hypertension 16.7% and inadequate physical activity 7.6%. Bipolar mood disorder was significantly associated with presence of MetS compared to schizophrenia with OR 2.17, 95% CI (1.14-4.14) p=0.019. Conclusion Prevalence of most CVRF was found to be high in SMI and significant associations were observed between having a diagnosis of BMD and having MetS.