IJCS | Volume 32, Nº5, September/October 2019

DOI: 10.5935/2359-4802.20190027 517 ORIGINAL ARTICLE International Journal of Cardiovascular Sciences. 2019;32(5):517-526 Mailing Address: Sarah de Melo Rocha Cabral Avenida Bougainville, 5115, Condomínio Mansão dos Morros. Postal Code: 64064-010, Teresina, Piauí - Brazil. E-mail: sarahmelo_9@hotmail.com Cardiovascular Risk and Metabolic Syndrome in Individuals with Mental Disorders Sarah de Melo Rocha Cabr al a nd Marize Melo dos Santo s Universidade Federal do Piauí (UFPI), Teresina, PI - Brazil Manuscript received April 04, 2017; revised manuscript September 21, 2018; accepted September 24, 2018. Abstract Background: Patients with mental disorders are more susceptible to cardiovascular diseases and metabolic disorders compared to the general population. Objective: To evaluate cardiovascular risk and metabolic syndrome in individuals with mental disorders. Materials andmethods: Across-sectional study, conductedat thePsychosocial CareCenters. Socioeconomic, clinical, biochemical and anthropometric data were collected using a standard form. Cardiovascular risk was assessed by the Framingham risk score. Metabolic syndrome (MS) was determined by the World Health- Organization (WHO), the National Cholesterol Education Program (NCEP) and the International Diabetes Federation (IDF) criteria. Data were analyzed by descriptive statistics, and associations were evaluated by the chi-square test and Fisher's exact test, as well as Odds Ratio. The significance level adopted for all statistical tests was 5%. Results: The chance of individuals diagnosed with MS be at intermediate-to-high cardiovascular risk was greater (12.22, 8.01 and 6.23 times higher according to WHO, NCEP and IDF criteria, respectively) than those without MS. Conclusion: A high percentage of patients with mental disorders were at intermediate / high cardiovascular risk, and this was significantly associated with MS. (Int J Cardiovasc Sci. 2019;32(5):517-526) Keywords: Cardiovascular Diseases/physiopathology; Mental Disorders; Metabolic Syndrome; Mental Health; Patient Care Team Psychosocial Support Systems. Introduction Psychiatric reform in Brazil was implemented with the objective of changing the model of mental health assistance from a hospital-centered one to a community- centered model, based on the principles of the Brazilian Unified Health System and focused on a humanized psychosocial rehabilitation. 1 ThePsychosocial CareCenters (CAPS) have become the main actors in this process, providingmultidisciplinary care, social interaction, active participation of the families, 2 and sociocultural inclusion of patients by intersectoral actions. 3 Studies have reported that individuals with mental disorders (MDs) are more likely to develop metabolic syndrome (MS) and coronary disease, especially due to poor access to a well-balanced diet and physical exercise, and also to pharmacotherapy, mainly psychotropics. 4,5 Metabolic syndrome is composed by several conditions, many of themcommonly seen inMDpatients, including hypertension, glucose intolerance, visceral fat accumulation, and dyslipidemia. Together, these factors have a negative impact onmetabolism, increasing the risk for type 2 diabetes mellitus and cardiovascular disease, and affecting patient’s quality of life. 6 Metabolic syndrome has gained much attention not only because of the high prevalence of its components, but also because of their association with cardiovascular risk. The syndrome is associated with a risk two times greater for cardiovascular diseases, such as infarction, stroke and cardiovascular mortality. 7 Grover et al., 8 and Speyer et al., 9 confirmed the high prevalence of cardiovascular risk factors and MS in MD patients, and reported premature death in this population, especially among schizophrenic patients.