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A four-year naturalistic prospective study of cardiometabolic disease in antipsychotic-treated patients.

Lookup NU author(s): Dr Paul Mackin, Anthony Waton, Helen Watkinson, Dr Peter Gallagher

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Abstract

The relationship between antipsychotic use and cardiovascular morbidity and mortality is controversial. There is a lack of long-term prospective studies investigating changes in cardiometabolic risk in patients treated with antipsychotic drugs. We report data from a 4-year prospective study. Patients (89) underwent detailed metabolic and cardiovascular risk assessment at 4-years which included anthropometric assessment, blood pressure, lipid profile, and an oral glucose tolerance test. We used the homeostatic model assessment to determine insulin resistance, and calculated 10-year cardiovascular risk scores. Mean age of subjects was 44.7 (+/- 11.5) years, and 52% were male. The prevalence of type 2 diabetes was 8%, and 38.4% fulfilled diagnostic criteria for the metabolic syndrome. With the exception of increased central adiposity over the 4-year follow-up period (p < 0.001), other cardiometabolic parameters were generally unchanged. There was a high prevalence of dyslipidaemia, but only 16.9% were prescribed lipid-lowering treatment. Commencing lipid-lowering therapy was associated with a reduction in cardiovascular risk score (OR 7.9, 95% CI = 1.3 to 48.7; p = 0.02). Patients established on longer-term antipsychotic treatment show less dramatic metabolic changes than those occurring in the early stages of treatment, but have a high burden of cardiovascular risk. Lipid-lowering therapy is associated with a significant reduction in cardiovascular risk. (C) 2010 Elsevier Masson SAS. All rights reserved.


Publication metadata

Author(s): Mackin P, Waton T, Watkinson HM, Gallagher P

Publication type: Article

Publication status: Published

Journal: European Psychiatry

Year: 2012

Volume: 27

Issue: 1

Pages: 50-55

Print publication date: 30/10/2010

ISSN (print): 0924-9338

ISSN (electronic): 1778-3585

Publisher: Elsevier Masson

URL: http://dx.doi.org/10.1016/j.eurpsy.2010.08.011

DOI: 10.1016/j.eurpsy.2010.08.011

PubMed id: 21036552


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