4.7 Article

Increased burden of cardiovascular risk among youth suicide attempters

Journal

PSYCHOLOGICAL MEDICINE
Volume 52, Issue 10, Pages 1901-1909

Publisher

CAMBRIDGE UNIV PRESS
DOI: 10.1017/S0033291720003736

Keywords

Cardiovascular risk; high blood pressure; smoking; obesity; suicide attempt; suicidal ideation

Funding

  1. National Institute of Mental Health (NIMH)
  2. Brain and Behavior Research Foundation
  3. American Foundation for Suicide Prevention (AFSP)
  4. NIMH
  5. AFSP
  6. Once Upon a Time Foundation
  7. Guilford Press
  8. National Institute of Mental Health
  9. National Institute on Drug Abuse
  10. American Foundation for Suicide Prevention
  11. National Heart, Lung, and Blood Institute
  12. Substance Abuse and Mental Health Services Administration
  13. HRSA
  14. Alkermes

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Young suicide attempters have a higher burden of cardiovascular risk compared to other high-risk individuals. Clinicians should pay attention to cardiovascular risk factors among suicide attempters to reduce their risk for cardiovascular events.
Background Suicide and cardiovascular disease rank among the leading causes of disability and premature mortality worldwide. Young adult suicide attempters are at increased risk of mortality from cardiovascular disease even compared to those with major depressive disorder suggesting an increased burden of cardiovascular risk factors. We compared the cardiovascular risk burden between youth attempters and other high-risk individuals. Methods Participants were from the Collaborative Psychiatric Epidemiology Surveys (CPES), a U.S. population-based study, aged 18-30 years [suicide attempt (SA): n = 303; suicidal ideation (SI): n = 451; controls: n = 3671]; and psychiatric inpatients admitted for a SA (n = 38) or SI (n = 40) and healthy controls (n = 37) aged 15-30 years. We computed a cardiovascular risk score and high- and low-risk latent classes based on risk factors of high blood pressure, obesity, and smoking. Results Suicide attempters showed an increased cardiovascular risk score (CPES: B = 0.43, 95% confidence interval (CI) 0.31-0.54, p < 0.001; inpatient sample: B = 1.61, 95% CI 0.53-2.68, p = 0.004) compared to controls. They were also more likely to be classified in the high cardiovascular risk group (CPES: odds ratio (OR) 3.36, 95% CI 1.67-6.78, p = 0.001; inpatient sample: OR 9.89, 95% CI 1.38-85.39, p = 0.03) compared to those with SI (CPES: OR 1.15, 95% CI 0.55-2.39, p = 0.71; inpatient sample: OR 1.91, 95% CI 0.25-15.00, p = 0.53). Conclusions Youth attempters show an increased burden for cardiovascular risk compared to other high-risk individuals in inpatient and population-based samples. Clinicians should pay particular attention to cardiovascular risk factors among suicide attempters in order to reduce their risk for cardiovascular events.

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