Patients who have serious mental illness tend to die 10 to 20 years earlier than the general population. The leading cause of death in this population is cardiovascular disease (CVD). Studies examining CV risk among patients with serious mental illness have had methodological limitations. As part of a larger study aimed at reducing CV risk in patients with serious mental illness, researchers estimated 10- and 30-year CV risk in primary care patients with and without serious mental illness.

To be included in the serious mental illness group, patients had to have two or more outpatient diagnostic codes or one or more inpatient diagnostic codes for a serious mental illness (bipolar disorder, schizophrenia, or schizoaffective disorder) documented in the electronic health record in the two years before the index date. For patients 40 to 75 years of age who didn't have CVD, 10-year CV risk was estimated using the atherosclerotic CVD risk score. For patients 18 to 59 years of age who didn't have CVD, 30-year CV risk was estimated using the Framingham risk score.

The final sample comprised 579,924 patients without serious mental illness and 11,333 with serious mental illness. After adjustment for age, race, ethnicity, sex, and insurance coverage, estimated 10-year CV risk in patients 40 to 75 years of age was significantly higher in those who had serious mental illness compared with those who did not. For those 18 to 59 years of age, having a diagnosis of serious mental illness was associated with 1.92 greater odds of being in a higher risk group compared with patients without serious mental illness.