Abstract:
Introduction Lifestyle factors such as smoking, alcohol use, suboptimal diet, and inadequate physical activity have
been associated with increased risk of cardiovascular diseases. There are limited data on these risk factors among
patients with psychosis in low- and middle-income countries.
Objectives This study aimed to establish the prevalence of lifestyle cardiovascular risk factors, and the 10-year
cardiovascular risk scores and associated factors in patients with psychosis compared to controls at Moi Teaching and
Referral Hospital in Eldoret, Kenya.
Methods A sample of 297 patients with schizophrenia, schizoaffective disorder, or bipolar mood disorder; and
300 controls matched for age and sex were included in this analysis. A study specific researcher-administered
questionnaire was used to collect data on demographics, antipsychotic medication use, smoking, alcohol intake, diet,
and physical activity. Weight, height, abdominal circumference, and blood pressure were also collected to calculate
the Framingham 10-year Cardiovascular Risk Score (FRS), while blood was drawn for measurement of glucose level
and lipid profile. Pearson’s chi-squared tests and t-tests were employed to assess differences in cardiovascular risk
profiles between patients and controls, and a linear regression model was used to determine predictors of 10-year
cardiovascular risk in patients.
Results Compared to controls, patients with psychosis were more likely to have smoked in their lifetimes (9.9% vs.
3.3%, p=0.006) or to be current smokers (13.8% vs. 7%, p=0.001). Over 97% of patients with psychosis consumed
fewer than five servings of fruits and vegetables per week; 78% engaged in fewer than three days of vigorous exercise
per week; and 48% sat for more than three hours daily. The estimated 10-year risk of CVD was relatively low in this
study: the FRS in patients was 3.16, compared to 2.93 in controls. The estimated 10-year cardiovascular risk in patients was significantly associated with female sex (p=0.007), older patients (p<0.001), current tobacco smoking (p<0.001),
and metabolic syndrome (p<0.001).
Conclusion In the setting of Eldoret, there is suboptimal physical exercise and intake of healthy diet among patients
with psychosis and controls. While the estimated risk score among patients is relatively low in our study, these data
may be useful for informing future studies geared towards informing interventions to promote healthy lifestyles in this
population.
