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Article

Antipsychotics and Risks of Cardiovascular and Cerebrovascular Diseases and Mortality in Dwelling Community Older Adults

by
Sylvie Perreault
1,2,*,
Laurie-Anne Boivin Proulx
3,
Judith Brouillette
4,
Stéphanie Jarry
5 and
Marc Dorais
6
1
Faculty of Pharmacy, Université de Montréal, Montreal, QC H3C 3J7, Canada
2
Centre de Recherche en Santé Publique (CReSP), Partenaire CIUSSS du Centre-Sud-de-l’Île-de-Montréal et l’Université de Montréal, Montreal, QC H3L 1M3, Canada
3
Department of Cardiology, Faculty of Medicine, University of Ottawa Heart Institute, Ottawa, ON K1Y 4W7, Canada
4
Department of Psychiatry and Addictology, Université de Montréal, Montreal, QC H3L 1M3, Canada
5
Department of Anesthesiology, Montreal Heart Institute, Université de Montréal, Montreal, QC H3L 1M3, Canada
6
StatSciences Inc., Notre-Dame-de-l’Île-Perrot, QC H3L 1M3, Canada
*
Author to whom correspondence should be addressed.
Pharmaceuticals 2024, 17(2), 178; https://doi.org/10.3390/ph17020178
Submission received: 27 December 2023 / Revised: 24 January 2024 / Accepted: 26 January 2024 / Published: 30 January 2024

Abstract

This study aims to investigate the effect of antipsychotic agents on cardiovascular and cerebrovascular diseases (CVD/CEV) and mortality risks in the older population living in a community. A cohort of 42,650 new users of antipsychotic agents was built using Quebec healthcare databases (1998–2011). The outcomes were CVD/CEV and mortality incidence in 5 years of follow-up in the total cohort, sub-cohort of patients with no schizophrenia/dementia, sub-cohort with schizophrenia, and sub-cohort with dementia. Comparisons were made between the new users who continued the treatment (adherent level ≥ 60%) vs. those ceasing treatment (adherence level < 60%) using inverse probability of treatment weighting and Cox models. Comparing high adherence vs. low levels, CVD/CEV risk was increased by 36% in the sub-cohort with schizophrenia for atypical antipsychotic users and by 25% in the sub-cohort with dementia for typical antipsychotic users. An increasing mortality risk of 2- to 3-fold was linked with the typical antipsychotic use in all cohorts except the sub-cohort with schizophrenia; in addition, mortality risk is linked with the use of high vs. low doses. Antipsychotics were not linked with CVD/CEV risk, except for atypical antipsychotics in patients with schizophrenia and typical antipsychotics in patients with dementia. The mortality risk was linked with the use of typical antipsychotics and the dose used.
Keywords: antipsychotics; risk of cardiovascular diseases; cerebrovascular diseases and mortality antipsychotics; risk of cardiovascular diseases; cerebrovascular diseases and mortality

Share and Cite

MDPI and ACS Style

Perreault, S.; Boivin Proulx, L.-A.; Brouillette, J.; Jarry, S.; Dorais, M. Antipsychotics and Risks of Cardiovascular and Cerebrovascular Diseases and Mortality in Dwelling Community Older Adults. Pharmaceuticals 2024, 17, 178. https://doi.org/10.3390/ph17020178

AMA Style

Perreault S, Boivin Proulx L-A, Brouillette J, Jarry S, Dorais M. Antipsychotics and Risks of Cardiovascular and Cerebrovascular Diseases and Mortality in Dwelling Community Older Adults. Pharmaceuticals. 2024; 17(2):178. https://doi.org/10.3390/ph17020178

Chicago/Turabian Style

Perreault, Sylvie, Laurie-Anne Boivin Proulx, Judith Brouillette, Stéphanie Jarry, and Marc Dorais. 2024. "Antipsychotics and Risks of Cardiovascular and Cerebrovascular Diseases and Mortality in Dwelling Community Older Adults" Pharmaceuticals 17, no. 2: 178. https://doi.org/10.3390/ph17020178

APA Style

Perreault, S., Boivin Proulx, L.-A., Brouillette, J., Jarry, S., & Dorais, M. (2024). Antipsychotics and Risks of Cardiovascular and Cerebrovascular Diseases and Mortality in Dwelling Community Older Adults. Pharmaceuticals, 17(2), 178. https://doi.org/10.3390/ph17020178

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