Background: Second-generation antipsychotics (SGAs) are used to treat mental illness in children but have side effects including weight gain, dyslipidemia, hypertension, and risk for type 2 diabetes. These side effects are well-known risk factors for cardiovascular disease. However, little is known about the cardiovascular health of SGA-treated children.
Methods: Cross-sectional study of children (aged 6-18 years) with mental illness that were SGA-treated (n=47) or SGA-naïve (n=37), and control children (n=83, no mental illness). Anthropometrics and a fasting blood sample were collected. Subclinical indicators of atherosclerosis were assessed. Central pulse-wave velocity (PWV) by standard M-mode echocardiography and Doppler tracing, an indicator of arterial stiffness, and carotid intima-media thickness (cIMT) were assessed.
Results: SGA-treated children had greater BMI z-scores (p<0.001) and higher (p<0.001) prevalence of overweight/obesity (BMI ≥85th percentile for age and sex) than SGA-naïve and control children. SGA-treated children had higher fasting plasma insulin (p=0.016) and 21.7% had hyperinsulinemia (fasting insulin ≥100pmol/L) compared to 12.9% of SGA-naïve children. No differences in fasting glucose or circulating lipids were observed. Hypertension was observed in 14.9% of SGA-treated children, compared to 5.4% of SGA-naïve and 6.0% of control children. SGA-treated (p=0.002) and SGA-naive children (p<0.001) had higher PWV compared to controls (adjusted for age, sex, BMI, systolic blood pressure). No effect of SGAs or mental health diagnosis on cIMT was observed.
Conclusion: Children with mental illness have greater arterial stiffness than control children.
A.M. Henderson: None. N. Islam: None. G.G. Sandor: None. C. Panagiotopoulos: Advisory Panel; Self; Dexcom, Inc. A.M. Devlin: None.
British Columbia Mental Health & Substance Use Services