IJCS | Volume 32, Nº5, September/October 2019

524 Cabral Cardiovascular risk and metabolic syndrome Int J Cardiovasc Sci. 2019;32(5):517-526 Original Article in women than men in our study, since mean age was higher in the former than in the latter. Based on the Framingham Heart Study, it is important to consider the percentage of intermediate/ high risk for cardiovascular diseases in our study population. Although apparently low – 18.12% – the percentage was meaningful considering the importance of the diagnosis. Besides, this result cannot be compared with that reported in previous studies and populations, since our study is a pioneer study on the theme. The chance of the patients diagnosed with MS be at intermediate/high risk for cardiovascular disease was elevated according to the three evaluation criteria for MS. In addition, it is worth pointing out that, although the IDF criteria have been the most widely described in the literature, despite the most conservative, the WHO criteria were the most sensitive in showing that individuals with MS were at intermediate/high risk for cardiovascular disease. Considering these data and the study by Tseng et al., 21 which showed a higher prevalence not only of MS but also of cardiovascular disease in individuals with MDs, it is reasonable to suggest that the percentage of intermediate/high risk for cardiovascular disease and of cardiovascular risk is higher in psychiatric population as compared with the general population. Limitations of the study correspond to limitations of the Framingham risk score, including – the absolute cardiovascular risk in participants in the Framingham study is not necessarily the same that observed in other populations; some risk factors known to be important in cardiovascular diseases were not considered in the development of the score such as diet, body weight and physical exercise; finally, the risk has a one-way relationship, i.e. the reduction in one risk factor does not necessarily reduces cardiovascular risk. In addition, differences in the cut-off points for the risk factors used by the different MS criteria may be a source of bias between the associations. Also, limitations intrinsic of cross- sectional studies make it difficult to establish a causal relationship, in this case, between risk factor exposure and development of disease. Although much effort has been devoted to determine the risk factors to which the psychiatric population are exposed, there are still many challenges to guarantee the right to health for this population. These data can serve as a basis for the planning of actions that contribute to increase life expectancy and improve the quality of life of these patients. Conclusion Our findings confirm the sociodemographic profile of social disadvantage and the vulnerability for cardiovascular risk factors in patients attending CAPSs. The prevalence of MS, established by the NCEP and the IDF diagnostic criteria, was high in this population, especially in patients with schizotypal disorders. In addition, our results indicate a high prevalence of intermediate/high cardiovascular risk in psychiatric patients and its significant association with MS. Acknowledgments We thank Teresina Municipal Health Foundation for acknowledging the importance of the study and for granting authorization for its conception. We thank the patients and the staff of the Psychosocial Care Center of the southeast region in Teresina, Brazil, for their decisive contribution to this study. Author contributions Conception and design of the research: Cabral SMR, Santos MM. Acquisition of data: Cabral SMR. Analysis and interpretation of the data: Cabral SMR, Santos MM. Writing of the manuscript: Cabral SMR. Critical revision of the manuscript for intellectual content: Cabral SMR, Santos MM. Potential Conflict of Interest No potential conflict of interest relevant to this article was reported. Sources of Funding The authors declare there was no external funding for the study, except for the materials used for blood sample collection, which were provided at no charge by Raul Bacelar Laboratory of Teresina municipal health system, Brazil. Study Association This article is part of the thesis of master submitted by Sarah de Melo Rocha Cabral, from Universidade Federal do Piauí .