Hearts and Minds
Mental Illness and Heart Disease
People living with mental illness are often at higher risk for heart disease and much of that risk is preventable. Knowledge is power!
People living with mental illness are more likely to have classic heart-risk factors, such as cigarette smoking, obesity, diabetes, elevated cholesterol and hypertension (high blood pressure), all of which can be made worse by some antipsychotic medications. In 2009, the American Diabetes Association (ADA) and the American Psychiatric Association (APA) produced a consensus statement addressing this concern and calling for more screenings and preventive care for certain individuals living with mental illness whose treatment includes second-generation, atypical antipsychotic medications (SGAs). The collaboration and the resultant consensus statement help to bring attention to this critical health concern.
Overall, America has reduced its heart disease risk based on lessons from a 50-year research project on the town of Framingham, Mass., outside Boston, where researchers followed thousands of residents to help understand what causes heart disease. The Framingham Heart Study produced the idea of "risk factors" and helped to make many connections for predicting and preventing heart disease.
Unfortunately, many people who live with mental illness are not enjoying a reduction in heart risk. There are many reasons for this problem, which you will learn about throughout the NAMI Hearts & Minds program.
There are five major preventable risks identified in the Framingham Heart Study that may impact people who live with mental illness. These risks are:
- elevated cholesterol; and
- high blood pressure (also called hypertension).
These risk factors can be modified; with attention, people living with mental illness can enjoy a higher quality of life. Other risk factors such as age, gender, family history and even a history of psychological trauma cannot be changed, but they need to be understood to assess any risk as well as the opportunities for prevention.
Once you learn more about these risk factors, it will be clear why people living with mental illness are at higher risk for cardiac problems and premature death. In addition, some people living with mental illness may have additional (yet reversible) heart-risk factors. These include:
- substance abuse;
- poor dental care;
- inactivity/lack of exercise;
- inadequate or poor primary medical care; and
- medical care that is not culturally competent.