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People With Schizophrenia at Higher Risk of Heart Failure

Individuals with schizophrenia were found to have a higher risk of heart failure but not because of higher blood pressure. Researchers analyzed genome-wide association studies that explored schizophrenia, heart failure, heart disease, blood pressure, and heart rate variability. Results were published in the Schizophrenia Bulletin.

Previous studies have linked schizophrenia to cardiovascular disease and heart failure, showing that these individuals have a 15 to 20 year shorter life expectancy than that of the general population. The researchers wanted to explore the connection between the disorder and the disease.

The researchers examined genomic data from the largest-available European genome-wide association study on schizophrenia. They used bidirectional Mendelian randomization to assess evidence for schizophrenia and cardiovascular disease.

The researchers found evidence that schizophrenia increases the risk of heart failure (95% CI=0.003−0.051, P =0.027). The researchers also found a link to heart rate variability but found weak evidence of an association between high blood pressure and schizophrenia. They also found no significant evidence of a genetic correlation.

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Although the study used powerful analyses, it may have suffered from selection bias because individuals with severe diseases may not have been able to participate in research. There may have also been temporality issues. Schizophrenia often manifests in young adulthood, while heart disease manifests later in life.

“Our findings are in line with the notion that schizophrenia is characterized by a systemic dysregulation of the body, including inflammation and oxidative stress, which promotes cardiac alterations and ultimately heart failure,” the researchers concluded.

“This implies that changing health behaviors — while useful to improve health — is not sufficient to reduce cardiovascular mortality among patients with schizophrenia. To prevent heart failure, priority should lie with optimal treatment and early-stage interventions, thereby preventing detrimental systemic effects.”


Veeneman RR, Vermeulen JM, Abdellaoui A, et al. Exploring the relationship between schizophrenia and cardiovascular disease: a genetic correlation and multivariable Mendelian randomization study. Schizophr Bull. Published online November 3, 2021. doi:10.1093/schbul/sbab132

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Source: Psychiatry Advisor