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Cardiovascular risk associated with chronic treatment of paliperidone, olanzapine, risperidone and aripiprazole

Published online by Cambridge University Press:  27 August 2024

A. L. Montejo*
Affiliation:
1Psychiatry, University of Salamanca. IBSAL
C. Bermejo
Affiliation:
2Neurociencias, IBSAL
J. Matías
Affiliation:
3Psychiatry, Complejo Asistencial Salamanca. IBSAL, Salamanca, Spain
T. Martín
Affiliation:
3Psychiatry, Complejo Asistencial Salamanca. IBSAL, Salamanca, Spain
J. Matías-Polo
Affiliation:
3Psychiatry, Complejo Asistencial Salamanca. IBSAL, Salamanca, Spain
Y. Santana
Affiliation:
3Psychiatry, Complejo Asistencial Salamanca. IBSAL, Salamanca, Spain
J. López-López
Affiliation:
3Psychiatry, Complejo Asistencial Salamanca. IBSAL, Salamanca, Spain
R. de Alarcón
Affiliation:
1Psychiatry, University of Salamanca. IBSAL
J. M. Acosta
Affiliation:
2Neurociencias, IBSAL
*
*Corresponding author.

Abstract

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Introduction

Weight gain, QT interval prolongation, and dyslipidemias associated with the chronic use of some antipsychotic medications can explain a higher prevalence of cardiovascular risk in these psychiatric population. The D’Agostino Index include some factors such as age, total cholesterol, high-density lipoproteins, systolic blood pressure increased, antihypertensive treatment, smoking, and diabetes, to estimate an individual’s risk (low, moderate or severe) of developing a cardiovascular event through a period of 10 years or throughout the patient’s lifetime.

Objectives

To compare the degree of cardiovascular risk using the D’Agostino Index, among different antipsychotic medications.

Methods

An estimation of cardiovascular risk (low, moderate, or high) was performed with the D´Agostino index in a sample of 144 patients (82 men and 62 women) mean age 45,2 +/- 10.13. All patients were treated for at least one year at a therapeutic dose and adhered to their treatment regimen correctly. Subjects with some relevant pre-existing unstable heart disease were excluded. All patients previously provided informed consent and were of legal age. Clinical data on medical history, concomitant medications, and risk factors were collected. A completed physical exam, waist circumference, lab sample, a lifestyle scale, and an evaluation of vital signs in accordance with European Society of Hypertension were evaluated. Statistical analysis was carried out using the statistical software SPSS version 26.0. A significance level α=0.05 was considered throughout the study.

Results

The four most consumed antipsychotics were risperidone 9.72% (n=14), paliperidone 25.7% (n=37), olanzapine 14.6% (n=21), and aripiprazole 34.7% (n=50). Descriptively, it was observed that the drugs most associated with moderate or high risks were paliperidone (37.8%) and olanzapine (33.3%), risperidone (28.6 %). Aripiprazol (22%) was the less associated compound with moderate/high cardiovascular risk.

Conclusions

Subjects treated with olanzapine and paliperidone showed a higher association with cardiovascular risk. Predicting cardiovascular risk could provide individual benefits by enabling lifestyle modifications, pharmacological treatment changes, or closer monitoring to reduce cardiovascular risk.

Disclosure of Interest

A. Montejo Grant / Research support from: This study has been funded by the Instituto de Salud Carlos III (ISCIII) through the project PI19/1596 and co-funded by the European Union., C. Bermejo: None Declared, J. Matías: None Declared, T. Martín: None Declared, J. Matías-Polo: None Declared, Y. Santana: None Declared, J. López-López: None Declared, R. de Alarcón: None Declared, J. Acosta: None Declared

Type
Abstract
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2024. Published by Cambridge University Press on behalf of European Psychiatric Association
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