Cardiovascular risk associated with antipsychotic treatment in a real-world cohort

Objective: To evaluate cardiovascular (CV) risk associated with long-term antipsychotic treatment in a real-world cohort. 

Methods: A cross-sectional study was conducted in 75 patients diagnosed with schizophrenia or schizoaffective disorder under antipsychotic therapy for more than five years. Clinical parameters including blood pressure, lipid profile, glucose, HbA1c and C-reactive protein were measured. CV risk was categorized according to IAS-AGLA criteria. 

Results: The mean age was 47 ± 15 years, with 47% females. Mean cholesterol was 195.5 ± 40 mg/dL, LDL 118.4 ± 33.8 mg/dL, HDL 49.0 ± 17.2 mg/dL, and triglycerides 151.7 ± 75.4 mg/dL. Ten-year CV risk was >10% in 28% of patients. Sixteen percent required lipid-lowering therapy and 14.5% antihypertensive treatment. Patients receiving GABAergic drugs (valproate, escitalopram, topiramate, diazepam) showed a protective effect against high CV risk (OR=17, p=0.049). 

Conclusion: Nearly one-third of patients under chronic antipsychotic therapy demonstrated elevated CV risk. These results reinforce the importance of preventive strategies, structured monitoring programs, and the potential value of adjunctive medications with protective metabolic effects.