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Temporal trends in cardiovascular disease risk factor profiles in a population-based schizophrenia sample: a repeat cross-sectional study
  1. Maria Chiu1,2,
  2. Farah Rahman1,
  3. Simone Vigod1,2,3,
  4. Andrew S Wilton1,
  5. Paul Kurdyak1,2,4
  1. 1 Research and Analysis, Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
  2. 2 Faculty of Medicine and Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
  3. 3 Women’s College Research Institute, Women’s College Hospital, Toronto, Ontario, Canada
  4. 4 Health Systems Research, Social and Epidemiological Research Program, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
  1. Correspondence to Dr Maria Chiu, Mental Health and Addictions Program, Institute for Clinical Evaluative Sciences, Toronto ON M4N 3M5, Canada; maria.chiu{at}


Background People with schizophrenia have an increased burden of cardiovascular diseases (CVD); however, little is known about the cardiovascular risk factor profiles of non-institutionalised individuals with schizophrenia. This study estimated the prevalence of CVD risk factors in a population-based sample of Canadians with and without schizophrenia.

Methods Ontario respondents of the Canadian Community Health Survey were linked to administrative health databases; using a validated algorithm, we identified 1103 non-institutionalised individuals with schizophrenia and 156 376 without schizophrenia. We examined the prevalence of eight CVD risk factors: smoking, diabetes, hypertension, obesity, physical inactivity, fruit/vegetables consumption, psychosocial stress and binge drinking. To examine temporal trends, we compared prevalence estimates from 2001–2005 to 2007–2010.

Results The prevalence of most CVD risk factors was significantly higher among those with schizophrenia than the general population. Obesity and diabetes prevalence increased by 39% and 71%, respectively, in the schizophrenia group vs 11% and 24%, respectively, in the non-schizophrenia group between the two time periods. Unlike the general population, smoking rates among those with schizophrenia did not decline. Almost 90% of individuals with schizophrenia had at least one CVD risk factor and almost 40% had ≥3 co-occurring risk factors.

Conclusion Individuals with schizophrenia had a greater prevalence of individual and multiple CVD risk factors compared with those without schizophrenia, which persisted over time. Our findings suggest that public health efforts to reduce the burden of CVD risk factors have not been as effective in the schizophrenia population, thus highlighting the need for more targeted interventions and prevention strategies.

  • schizophrenia
  • cardiovascular disease
  • risk factors

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  • Contributors MC was the principal investigator, conceived the study and prepared the first draft of the manuscript. ASW performed the statistical analyses. MC, FR, SV, ASW and PK interpreted the data, critically revised the manuscript for important intellectual content and approved the final version of the manuscript. ASW had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

  • Funding This work was supported by the Ministry of Health and Long-Term Care (MOHLTC) and was part of the Mental Health and Addictions Scorecard and Evaluation Framework (MHASEF) project at the Institute for Clinical Evaluative Sciences (ICES). The sponsor did not participate in the design and conduct of the study, collection, management, analysis and interpretation of the data; or preparation, review or approval of the manuscript and the decision to submit the manuscript for publication. Parts of this material are based on data and information compiled and provided by Cancer Care Ontario (CCO). Parts of this material are also based on data and/or information compiled and provided by the Canadian Institute for Health Information (CIHI). However, the analyses, conclusions, opinions and statements expressed in the material are those of the author(s), and not necessarily those of CIHI. No endorsement by ICES, the Ontario MOHLTC, CIHI or CCO is intended or should be inferred. All decisions regarding study design, publication and data analysis were made independent of the funding agencies.

  • Competing interests None declared.

  • Ethics approval Our study was approved by the Research Ethics Board at Sunnybrook Health Sciences Centre.

  • Provenance and peer review Not commissioned; externally peer reviewed.