Ideal cardiovascular health and its association with sedentary behaviour and fitness in psychiatric patients. The PsychiActive project

Nutr Metab Cardiovasc Dis. 2018 Sep;28(9):900-908. doi: 10.1016/j.numecd.2018.05.003. Epub 2018 Jun 10.


Background and aims: Ideal cardiovascular health (CVH) was defined as meeting ideal levels of 4 health behaviours (smoking, body mass index, physical activity, and diet) and 3 biological factors (blood pressure, total cholesterol, and glucose) and is inversely related to cardiovascular disease and mortality. However, the prevalence of ideal CVH in patients with severe mental illness and the possible independent associations of sedentary behaviour and fitness with CVH score are unexplored.

Methods and results: This study included 142 (34 women) outpatients with severe mental illness (primarily schizophrenia, n = 92). CVH was evaluated according to the American Heart Association guidelines. Sedentary behaviour, cardiorespiratory fitness, and muscular strength were measured by an activity-monitor, the 6-min walk test, and handgrip dynamometry. Cardiorespiratory fitness and strength values were combined in a composite fitness score. The prevalence of ideal CVH was: non-smoking (47.9%), body mass index (16.9), physical activity (83.1%), diet (10.4%), blood pressure (40.4%), total cholesterol (62.9%), and plasma glucose (66.7%). Low levels of sedentary behaviour and high cardiorespiratory, strength, and composite fitness score were associated with meeting the ideal threshold in most CVH metrics and having higher global CVH score; however, only cardiorespiratory and composite fitness score remained significantly related to global CVH score independent of sedentary behaviour and multiple confounders.

Conclusions: Patients with severe mental illness generally have low prevalence of ideal CVH metrics, especially diet and body mass index. Additionally, our findings suggest the need or considering cardiorespiratory fitness, regardless of sedentary behaviour, to promote ideal CVH in this population.

Keywords: Cardiovascular disease; Mental disorders; Physical fitness; Sedentary lifestyle.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Biomarkers / blood
  • Blood Glucose / analysis
  • Blood Pressure
  • Body Mass Index
  • Cardiorespiratory Fitness*
  • Cardiovascular Diseases / epidemiology
  • Cardiovascular Diseases / physiopathology
  • Cardiovascular Diseases / prevention & control*
  • Cardiovascular Diseases / psychology
  • Cholesterol / blood
  • Cross-Sectional Studies
  • Diet / adverse effects
  • Exercise Tolerance
  • Female
  • Health Status
  • Humans
  • Male
  • Mental Disorders / epidemiology
  • Mental Disorders / physiopathology*
  • Mental Disorders / psychology*
  • Middle Aged
  • Muscle Strength
  • Physical Fitness*
  • Risk Assessment
  • Risk Factors
  • Sedentary Behavior*
  • Severity of Illness Index
  • Smoking / adverse effects
  • Smoking / epidemiology
  • Smoking / psychology
  • Spain / epidemiology


  • Biomarkers
  • Blood Glucose
  • Cholesterol