Risk factors for metabolic and cardiovascular disease in inpatients with severe mental illness

Patients with severe mental illness (SMI) have increased burden of somatic illnesses, especially cardiovascular disease. Characterizing the cardiovascular risk profile of patients with SMI is therefore crucial to understanding how to decrease morbidity and mortality in these vulnerable populations. In this observational study, entropy balancing (a form of propensity score matching) was used to compare cardiometabolic health in a sample of the general population from the National Health and Nutrition Examination Survey (NHANES) datasets to inpatients hospitalized in a large, urban, academic psychiatric hospital in Harris County, Texas. Data were analyzed using independent linear regression models for blood pressure, blood glucose, TG:HDL ratio, total cholesterol, and body mass index as outcome variables. Systolic blood pressure (F=34.75, p<0.0001), diastolic blood pressure (F=90.53, p<0.0001), blood glucose (F=12.89, p<0.0001), and the TG:HDL ratio (F=3.16, p<0.0001) were all elevated in the psychiatric inpatient sample vs. the NHANES sample. Contrary to expectations, total cholesterol (F=32.18, p<0.0001) and BMI (F=15.05, p<0.0001) were lower in this sample vs. the NHANES sample. Patients hospitalized with SMI show a cardiometabolic profile which confers greater risk of diabetes- and hypertension-related mortality. Approaches should be developed to target indicators of cardiometabolic health in this population to reduce long-term mortality.