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Obesity ‘does not predict CHD risk in patients on atypical antipsychotics’
By Mark Cowen
07 January 2011
Eur Arch Psychiatry Clin Neurosci 2010; Advance online publication

MedWire News: Obesity is not an independent predictor for the 10-year risk for coronary heart disease (CHD) events in patients without the metabolic syndrome who are taking atypical (second generation) antipsychotics, study findings suggest.

"Weight gain leading to obesity is a frequent adverse effect of treatment with atypical antipsychotics," explain Peter Manu (North Shore-Long Island Jewish Health System, Glen Oaks, New York, USA) and team.

"However, the degree of its independent contribution to the risk of CHD events in patients treated with these drugs has not been elucidated," they add.

To address this, the team studied 44 obese patients (54.5% men) with a body mass index (BMI) greater than 30 kg/m2 and 83 normal-weight patients (47.0% men) with a BMI of 18.5-24.9 kg/m2 who were all treated with atypical antipsychotics.

The mean age of the obese and normal-weight patients was 38.1 and 39.9 years, respectively. None of the patients had the metabolic syndrome or were taking antihypertensive, hypoglycemic, or lipid-lowering drugs.

The patients' 10-year risk for CHD events (angina pectoris, myocardial infarction, and sudden death), expressed as a percentage, was assessed using the National Cholesterol Education Program version of the Framingham score, which uses data regarding age, gender, smoking status, blood pressure, total cholesterol, and high-density lipoprotein cholesterol.

The team found that the absolute 10-year risk of CHD events was very low and almost identical in obese and normal weight patients, at 2.3% versus 2.6%.

Furthermore, the risk was similar in obese and normal weight men, at 3.8% versus 2.8%, and obese and normal weight women, at 1.7% versus 1.5%.

"The validity of the 10-year prediction for risk of CHD events in the mentally ill based on the Framingham score system requires prospective confirmation," comment Manu and team in the European Archives of Psychiatry and Clinical Neuroscience.

Nevertheless, they conclude: "Obesity does not appear to be an independent predictor for the 10-year risk of CHD events in patients without metabolic syndrome treated with second-generation antipsychotics."

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2011

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