Healthy lifestyle habits and 10-year cardiovascular risk in schizophrenia spectrum disorders: An analysis of the impact of smoking tobacco in the CLAMORS schizophrenia cohort

AimWe analysed the impact of tobacco smoking over several healthy lifestyle habits along with the impact on 10-years cardiovascular event (CVE) risk in the CLAMORS schizophrenia cohort.MethodsThis analysis was performed within the scope of the CLAMORS study which included consecutive outpatients meeting DSM-IV criteria for schizophrenia spectrum disorder. Beside smoking history, data on usual healthy lifestyle habits included current exercise, saturated fat sparing diet, low-caloric diet, and daily dietary fibre, salt, caffeine and alcohol consumption were recorded. The 10-year CVE risk was calculated with Framingham function.Results1704 patients (61.1% male), 18 to 74 years were examined. Prevalence of smoking was 54.54% (95% CI: 52.16%–56.90%) significantly higher than in age and sex matched general population subjects, 31.51% (31.49%–31.52%); OR = 2.61 (2.37–2.87, p < 0.0001). After controlling by confounders smokers showed a 10-year CVE risk excess versus non-smokers of 2.63 (2.16–3.09), p < 0.001. Smoking cessation would reduce the likely of high/very high 10-year CVE risk (above 10%) by near 90% [OR = 0.10 (0.06–0.18), p < 0.0001]. Also, smokers were more likely to consume alcohol daily [4.13 (3.07–5.54), p < 0.0001] and caffeine [3.39 (2.72–4.23), p < 0.0001] than non-smoker patients with schizophrenia, and less likely to avoid daily consumption of salt [0.58 (0.43–0.78), p < 0.0001], saturated fat [0.71 (0.56–0.91), p = 0.006], high fibre diet [0.67 (0.53–0.84), p = 0.001], or to follow a low-caloric diet [0.63 (0.48–0.81), p < 0.0001]. Smokers also were less likely to do exercise habitually [0.62 (0.48–0.82, p = 0.001].ConclusionCompared with the general population, patients with schizophrenia showed significant higher prevalence of smoking. Smokers who stop smoking would benefit by a near 90% reduction in the likely of 10-year cardiovascular event risk above 10%.