Etiology of cardiovascular disease in patients with schizophrenia: current perspectives

Murat Emul,1 Tevfik Kalelioglu21Department of Psychiatry, Medical School of Cerrahpasa, Istanbul University, 2Department of Psychiatry, Bakirkoy Mental Health Research and Training Hospital, Istanbul, TurkeyAbstract: Cardiovascular morbidity and mortality are important problems among patients with s...

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Autores principales:	Emul M, Kalelioglu T
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2015
Materias:	Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/f9f28e218256489f8317bcdb82111395
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spelling	oai:doaj.org-article:f9f28e218256489f8317bcdb821113952021-12-02T01:17:20ZEtiology of cardiovascular disease in patients with schizophrenia: current perspectives1178-2021https://doaj.org/article/f9f28e218256489f8317bcdb821113952015-10-01T00:00:00Zhttps://www.dovepress.com/etiology-of-cardiovascular-disease-in-patients-with-schizophrenia-curr-peer-reviewed-article-NDThttps://doaj.org/toc/1178-2021Murat Emul,1 Tevfik Kalelioglu21Department of Psychiatry, Medical School of Cerrahpasa, Istanbul University, 2Department of Psychiatry, Bakirkoy Mental Health Research and Training Hospital, Istanbul, TurkeyAbstract: Cardiovascular morbidity and mortality are important problems among patients with schizophrenia. A wide spectrum of reasons, ranging from genes to the environment, are held responsible for causing the cardiovascular risk factors that may lead to shortening the life expectancy of patients with schizophrenia. Here, we have summarized the etiologic issues related with the cardiovascular risk factors in schizophrenia. First, we focused on heritable factors associated with cardiovascular disease and schizophrenia by mentioning studies about genetics–epigenetics, in the first-episode or drug-naïve patients. In this context, the association and candidate gene studies about metabolic disturbances in schizophrenia are reviewed, and the lack of the effects of epigenetic/posttranscriptional factors such as microRNAs is mentioned. Increased rates of type 2 diabetes mellitus and disrupted metabolic parameters in schizophrenia are forcing clinicians to struggle with metabolic syndrome parameters and related issues, which are also the underlying causes for the risk of having cardiometabolic and cardiovascular etiology. Second, we summarized the findings of metabolic syndrome-related entities and discussed the influence of the illness itself, antipsychotic drug treatment, and the possible disadvantageous lifestyle on the occurrence of metabolic syndrome (MetS) or diabetes mellitus. Third, we emphasized on the risk factors of sudden cardiac death in patients with schizophrenia. We reviewed the findings on the arrhythmias such as QT prolongation, which is a risk factor for Torsade de Pointes and sudden cardiac death or P-wave prolongation that is a risk factor for atrial fibrillation. For example, the use of antipsychotics is an important reason for the prolongation of QT and some other cardiac autonomic dysfunctions. Additionally, we discussed relatively rare issues such as myocarditis and cardiomyopathy, which are important for prognosis in schizophrenia that may have originated from the use of antipsychotic medication. In conclusion, we considered that the studies and awareness about physical needs of patients with schizophrenia are increasing. It seems logical to increase cooperation and shared care between the different health care professionals to screen and treat cardiovascular disease (CVD)-risk factors, MetS, and diabetes in patients with psychiatric disorders, because some risk factors of MetS or CVD are avoidable or at least modifiable to decrease high mortality in schizophrenia. We suggested that future research should focus on conducting an integrated system of studies based on a holistic biopsychosocial evaluation.Keywords: antipsychotic, cardiovascular risk, MetS, miRNA, QTc, schizophreniaEmul MKalelioglu TDove Medical PressarticleNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571Neurology. Diseases of the nervous systemRC346-429ENNeuropsychiatric Disease and Treatment, Vol 2015, Iss default, Pp 2493-2503 (2015)
institution	DOAJ
collection	DOAJ
language	EN
topic	Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
spellingShingle	Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429 Emul M Kalelioglu T Etiology of cardiovascular disease in patients with schizophrenia: current perspectives
description	Murat Emul,1 Tevfik Kalelioglu21Department of Psychiatry, Medical School of Cerrahpasa, Istanbul University, 2Department of Psychiatry, Bakirkoy Mental Health Research and Training Hospital, Istanbul, TurkeyAbstract: Cardiovascular morbidity and mortality are important problems among patients with schizophrenia. A wide spectrum of reasons, ranging from genes to the environment, are held responsible for causing the cardiovascular risk factors that may lead to shortening the life expectancy of patients with schizophrenia. Here, we have summarized the etiologic issues related with the cardiovascular risk factors in schizophrenia. First, we focused on heritable factors associated with cardiovascular disease and schizophrenia by mentioning studies about genetics–epigenetics, in the first-episode or drug-naïve patients. In this context, the association and candidate gene studies about metabolic disturbances in schizophrenia are reviewed, and the lack of the effects of epigenetic/posttranscriptional factors such as microRNAs is mentioned. Increased rates of type 2 diabetes mellitus and disrupted metabolic parameters in schizophrenia are forcing clinicians to struggle with metabolic syndrome parameters and related issues, which are also the underlying causes for the risk of having cardiometabolic and cardiovascular etiology. Second, we summarized the findings of metabolic syndrome-related entities and discussed the influence of the illness itself, antipsychotic drug treatment, and the possible disadvantageous lifestyle on the occurrence of metabolic syndrome (MetS) or diabetes mellitus. Third, we emphasized on the risk factors of sudden cardiac death in patients with schizophrenia. We reviewed the findings on the arrhythmias such as QT prolongation, which is a risk factor for Torsade de Pointes and sudden cardiac death or P-wave prolongation that is a risk factor for atrial fibrillation. For example, the use of antipsychotics is an important reason for the prolongation of QT and some other cardiac autonomic dysfunctions. Additionally, we discussed relatively rare issues such as myocarditis and cardiomyopathy, which are important for prognosis in schizophrenia that may have originated from the use of antipsychotic medication. In conclusion, we considered that the studies and awareness about physical needs of patients with schizophrenia are increasing. It seems logical to increase cooperation and shared care between the different health care professionals to screen and treat cardiovascular disease (CVD)-risk factors, MetS, and diabetes in patients with psychiatric disorders, because some risk factors of MetS or CVD are avoidable or at least modifiable to decrease high mortality in schizophrenia. We suggested that future research should focus on conducting an integrated system of studies based on a holistic biopsychosocial evaluation.Keywords: antipsychotic, cardiovascular risk, MetS, miRNA, QTc, schizophrenia
format	article
author	Emul M Kalelioglu T
author_facet	Emul M Kalelioglu T
author_sort	Emul M
title	Etiology of cardiovascular disease in patients with schizophrenia: current perspectives
title_short	Etiology of cardiovascular disease in patients with schizophrenia: current perspectives
title_full	Etiology of cardiovascular disease in patients with schizophrenia: current perspectives
title_fullStr	Etiology of cardiovascular disease in patients with schizophrenia: current perspectives
title_full_unstemmed	Etiology of cardiovascular disease in patients with schizophrenia: current perspectives
title_sort	etiology of cardiovascular disease in patients with schizophrenia: current perspectives
publisher	Dove Medical Press
publishDate	2015
url	https://doaj.org/article/f9f28e218256489f8317bcdb82111395
work_keys_str_mv	AT emulm etiologyofcardiovasculardiseaseinpatientswithschizophreniacurrentperspectives AT kalelioglut etiologyofcardiovasculardiseaseinpatientswithschizophreniacurrentperspectives
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Etiology of cardiovascular disease in patients with schizophrenia: current perspectives

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