A 10-Year Risk of Cardiovascular Disease among Patients with Severe Mental Illness at Mbarara Regional Referral Hospital, Southwestern Uganda

Abstract

Cardiovascular disease (CVD) is a leading cause of morbidity and mortality worldwide. Patients with severe mental illness (SMI) are at a higher risk for developing CVD and have a higher risk for harboring factors related to CVD. In addition to the effects of antipsychotic medications, unhealthy lifestyle factors, such as poor diet, inadequate physical activity, cigarette smoking, and sedentary behaviors, are known to be risk factors that may contribute to poor cardiovascular health in patients with SMI. Early identification of individuals at elevated risk of CVD is essential so that dietary and lifestyle modifications or pharmacological interventions can be prescribed to alleviate the risk of cardiovascular disease. The objective of the study was to determine the 10-year risk of cardiovascular disease among patients with severe mental illness at Mbarara Regional Referral Hospital, southwestern Uganda. We conducted a cross-sectional study at the outpatient mental health clinic of Mbarara Regional Referral Hospital, between October 2018 and March 2019. We used the Globorisk CVD risk score to estimate the 10-year risk of CVD among patients with SMI, using the online Globorisk calculator. Participants were then assigned to one of three categories depending on their 10-year CVD risk score: <3% (low), 3–10% (intermediate), and >10% (high). We calculated the risk scores of 125 participants aged 40-74 years. Most of the participants were female 75 (60%), had a diagnosis of bipolar disorder 75 (60%), and had mental illness for ≥10 years 57 (46%). Eighty five percent (85%) of the participants had intermediate to high 10-year risk of CVD (64% with intermediate and 21% with high risk). The average risk score was significantly higher in males compared to females, 8.82% versus 6.43%, p=0.016. We detected a high 10-year risk of CVD in a significant proportion of patients with SMI in southwestern Uganda. We recommend lifestyle modifications and pharmacological interventions to reverse risk or delay progression to CVD in this patient population.

Mbarara University Research Training Initiative: Experiences and Accomplishments of the MEPI Junior D43 TW010128 Award in Uganda

“… 20 Cardiovascular diseases research area. We realized 13 publications from the MURTI trainees in this area: (i) PMC5766276 21 (ii) https://doi.org/10.29392/001c.19464 ; 22 (iii) PMC7470164; 23 (iv) PMC7218768; 24 (v) PMC8077796; 25 (vi) https://doi.org/10.1007/s13410-021-00944-6 ; 26 (vii) https://doi.org/10.11604/pamj.2021.39.142.28620 (viii) PMC7367467; 28 (ix) PMC6877961; 29 (x) PMC7396089; 30 (xi) PMC7004860; 31 (xii) PMC6641537; 32 (xiii) PMC7592727. 33 Neurological disorders and stroke research area.…”

Mortality Among Patients Admitted in a Psychiatric Facility: A Single-Centre Review

“…11 Metabolic disease and other chronic medical conditions are common among patients and are implicated in their reduced lifespan and mortality compared to the general population. [11][12][13][14][15] These conditions put most patients at risk of premature death through heart attack and hypoglycemia, among others, if poorly controlled during admission. These conditions are due to patients associated with risky lifestyles such as substance use, obesity, physical inactivity, risky sexual practices, poor nutrition, and use of psychiatric medications.…”

“…34,35 Another way of preventing death among psychiatric patients is through to manage the risk of commonly occurring noncommunicable diseases (diabetes, hypertension, CVDs, and related heart attack) by providing and supporting services that increase healthy behaviours such as increased physical activities, healthy diet, and reducing/cessation of use of substances of addiction. 11,13…”

Ten-Year Risk of Fatal Cardiovascular Disease and its Association with Metabolic Risk Factors Among Waste Pickers in South Africa

“…The medical recommendation for the prevention of CVD needs to be based on an assessment of the "individual's total risk burden" not on a single risk factor [13,14]. There is evidence that risk factors tend to occur in clusters [15], and the majority of the individuals have more than one risk factors, which when combined leads to increased fatal CVD risk [16]. As a result, the use of the CVD risk score as the rst line of prevention among people who do not clinically indicate CVD symptoms is highly recommended [17].…”