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Obesity and coronary risk in patients treated with second-generation antipsychotics

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Abstract

Weight gain leading to obesity is a frequent adverse effect of treatment with atypical antipsychotics. However, the degree of its independent contribution to the risk of coronary heart disease events in patients treated with these drugs has not been elucidated. The aim of this study is to determine whether obesity is an independent risk factor for the 10-year risk of coronary heart disease events in psychiatric patients treated with atypical antipsychotics. We used the Framingham method, which is based on age, gender, blood pressure, smoking, and plasma levels of total and high-density lipoprotein cholesterol, to estimate the 10-year risk of coronary heart disease events in patients treated with second-generation antipsychotics who were obese (N = 44; mean age 38.1 years, 54.5% men) or normal weight (N = 83; mean age 39.9 years, 47.0% men). Excluded were patients with metabolic syndrome and those taking antihypertensive, hypoglycemic, and lipid-lowering drugs. The 10-year risk of coronary artery disease events was very low and virtually identical in the obese and normal weight patients (2.3 ± 3.5 vs. 2.6 ± 4.6, P = 0.68), despite excess of 12 BMI units (P < 0.0001) and 15.7 cm waist circumference (P < 0.0001) in the obese. The risk was similar in obese and normal weight men (3.8 ± 5.9 vs. 2.8 ± 3.4, P = 0.45) and women (1.7 ± 3.7 vs. 1.5 ± 2.5, P = 0.83). The validity of the 10-year prediction for risk of coronary heart disease events in the mentally ill based on the Framingham score system requires prospective confirmation. Obesity does not appear to be an independent predictor for the 10-year risk of coronary heart disease events in patients without metabolic syndrome treated with second-generation antipsychotics.

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Acknowledgments

We thank Dr. Anne Frederickson for her assistance with data collection. Supported in part by The Zucker Hillside Hospital Mental Advanced Center for Intervention and Services Research for the Study of Schizophrenia (MH074543-01) from the National Institute of Mental Health, Bethesda, MD.

Conflict of interest

Dr. Correll has been a consultant and/or advisor to or has received honoraria from: Actelion, AstraZeneca, Boehringer-Ingelheim, Bristol-Myers Squibb, Cephalon, Eli Lilly, IntraCellular Therapeutics, Ortho-McNeill/Janssen/J&J, GSK, Hoffmann-La Roche, Medicure, Otsuka, Pfizer, Schering-Plough, Sepracor/Sunovion, Supernus, Takeda and Vanda. Dr. Kane has been a consultant to Astra-Zeneca, Janssen, Pfizer, Eli Lilly, Bristol-Myers Squibb, Dainippon Sumitomo/Sepracor/Sunovion, Johnson & Johnson, Otsuka, Vanda, Proteus, Takeda, Targacept, IntraCellular Therapies, Merck, Lundbeck, Novartis, Rules Based Medicine and has received honoraria for lectures from Otsuka, Eli Lilly, Esai, Boehringer-Ingelheim, Bristol-Myers Squibb, and Janssen. Dr. Manu has served on the speaker/advisory boards of Eli Lilly, Pfizer, Bristol-Myers Squibb and Forest.

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Authors and Affiliations

  1. The Zucker Hillside Hospital, North Shore-Long Island Jewish Health System, 75-59 263rd Street, Glen Oaks, NY, 11004, USA

    Christoph U. Correll, John M. Kane & Peter Manu

  2. Albert Einstein College of Medicine, Bronx, NY, USA

    Christoph U. Correll, John M. Kane & Peter Manu

  3. The Feinstein Institute for Medical Research, North Shore-Long Island Health System, Manhasset, NY, USA

    Christoph U. Correll & John M. Kane

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  1. Christoph U. Correll
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Correspondence to Peter Manu.

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Correll, C.U., Kane, J.M. & Manu, P. Obesity and coronary risk in patients treated with second-generation antipsychotics. Eur Arch Psychiatry Clin Neurosci 261, 417–423 (2011). https://doi.org/10.1007/s00406-010-0177-z

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  • DOI: https://doi.org/10.1007/s00406-010-0177-z

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