A comprehensive cardiovascular disease risk profile in patients with schizophrenia

Patients with schizophrenia are physically inactive and have high prevalence of cardiovascular disease (CVD). Peak oxygen uptake (VO2peak) is one of the strongest predictors for CVD, yet is rarely investigated in this patient population, and how VO2peak relates to other conventional CVD risk measures in this population is unclear. We measured treadmill VO2peak along with daily physical activity assessed by triaxial accelerometry, body mass index (BMI), waist circumference, blood pressure, lipid profiles, and glucose in 48 outpatients (28 men, 35 +/- 10 (SD) years; 20 women, 35 +/- 12 years), diagnosed with schizophrenia, schizotypal, or delusional disorders (ICD-10; F20-29). The patients were compared with 48 age- and sex-matched healthy references (+/- 2 years) and normative data from the population. VO2peak was 34.5 +/- 8.7 mL/kg/min (men) and 26.4 +/- 7.0 mL/kg/min (women), which was 27% and 30% lower than healthy references, respectively (both P < 0.01). VO2peak was not associated with daily physical activity in men while a weak association was seen in women (steps per day: r(2) = 0.26; counts per minute: r(2) = 0.25; P < 0.05). BMI (26.0 +/- 6.1 kg/m(2)) revealed that patients were moderately overweight with a waist circumference of 103 +/- 17 cm. Lipid- and glucose levels, and blood pressure were all within normative range. Our data advocate the utilization of VO2peak assessment for CVD risk profile determination in patients with schizophrenia. Daily physical activity was poorly and inconsistently related to VO2peak, suggesting increased daily physical activity might not translate into improved VO2peak and CVD risk reduction.