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• W1966928808 abstract "ARDIOVASCULAR DISEASE (CVD), INCLUDING COROnary heart disease (CHD), stroke, and peripheral vascular disease, is the leading cause of death in the United States and most developed Western countries, and will remain so during the 21st century. 1 In 2004, CVD was listed as the underlying cause of death in 871517 of all 2398000 deaths (36.3%), or 1 of every 2.8 deaths in the United States, with CHD accounting for 52% and stroke for 17%. 2 During the past several decades, CVD mortality has markedly declined in the United States, from more than 50% to approximately 36% as the underlying cause of death. Recent data suggest that the decline is largely due to improved diagnosis and treatment rather than to major successes in primary prevention. In contrast, patients with severe mental illnesses, such as schizophrenia, bipolar disorder, and depression that together affect 5% to 10% of the US population, 3 lose 25 or more years of life expectancy, with the majority of the excess premature deaths due to CVD, not suicide. 4 In this Commentary, we summarize disparities in CVD mortality and prevention efforts comparing the general population and individuals with severe mental illnesses and suggest the urgent need for new paradigms. In the general US population, cigarette consumption has been the leading avoidable cause of all premature deaths, with the amount currently smoked representing a key measure of risk. 5 Smoking rates in the general population have declined from more than 50% in the 1950s to approximately 25% at present. 5 However, among patients with diagnosable mental illness, 50% to 80% are smokers and consume 34% to 44% of all cigarettes in the United States. 6 Although patients with severe mental illness are overrepresentedinstateprogramslikeMedicaid,somestatesdonot cover any form of tobacco-dependence treatment. 7 In addition, only a few states cover all treatments recommended intheUSPreventiveServicesTaskForceguidelinesonsmoking cessation. 7 Moreover, some states that cover tobaccodependence treatment require cost sharing, a serious disincentive for disabled patients with fixed income. 7" @default.
• W1966928808 created "2016-06-24" @default.
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• W1966928808 date "2007-10-17" @default.
• W1966928808 modified "2023-09-30" @default.
• W1966928808 title "Severe Mental Illness and Risk of Cardiovascular Disease" @default.
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• W1966928808 doi "https://doi.org/10.1001/jama.298.15.1794" @default.
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