Cardiovascular Disease Risk among Mental Illness Patients Is Reduced by Intervention

In patients with mental illness, researchers have found that intervention programs can reduce their risk of cardiovascular disease by nearly 13%. The new study by John Hopkins Medicine researchers found this relationship between people with serious mental illnesses such as schizophrenia, bipolar disorder, and major depression, and 10-year risk of heart attack or stroke.

People who suffer from mental illness have previously been found to have twice the rate of cardiovascular disease than the general population and are more likely to die of the disease. This is due to a high number of risk factors such as being overweight, getting less physical activity, having high cholesterol, blood pressure, or smoking.

People with mental illness have also been shown to commonly face special challenges in receiving heart-healthy interventions because of lack of attention, decision-making skills, and socioeconomic risk factors such as poverty, lack of social support, and access to healthy foods.

A Program to Improve Cardiovascular Health

“Our program, which incorporates counseling tied to care management and coordination, showed that it is possible to put together an effective program that can improve cardiovascular health and reduce the health care disparities of people with major mental illnesses,” says Gail Daumit, M.D., M.H.S., professor of medicine and psychiatry and behavioral sciences at the Johns Hopkins University School of Medicine.

The study included 132 participants with serious mental disorders who were given 18 months of intervention. They were compared to another 137 participants, also with mental disorders who received no interventions. Those in the intervention group were assigned a counselor and a nurse who helped guide them to adopt positive lifestyle behaviors such as eating a healthy diet, quitting smoking, and managing their cardiovascular health. A primary care provider also guided their treatments.

To help provide the conclusion of the study, researchers turned to the Framingham Risk Score for Hard Coronary Heart Disease, which predicts the 10-year risk of having a major cardiovascular event, such as a stroke or heart attack

“Although a few previous studies have examined the impact of intervening on a single risk factor, such as smoking or obesity, this investigation took the unique approach of developing and implementing a tailored, multi-level intervention to reduce risk,” says Catherine Stoney, Ph.D., deputy director of the Center for Translational Research and Implementation Science at the National Heart, Lung, and Blood Institute, part of the National Institutes of Health. “The findings suggest that incorporating this comprehensive intervention in a high-need, high-risk population can have a positive impact on cardiovascular risk scores.”

Although this practice is commonly used in health programs across the nation, until this study, there were no evidence-based interventions for nurses to implement that addressed cardiovascular risk in their patients. Researchers hope this information will help reduce the risk of cardiovascular disease in mental health patients who may have previously been overlooked.

“With a structured intervention, we believe that it would be feasible to use the existing framework to reduce cardiovascular risk in persons with serious mental illness nationwide,” says Daumit.