This meta-analysis aims to measure disparities in cardiovascular disease (CVD) screening/treatment in people with mental disorders, given the increased CVD incidence and mortality.Methods. PRISMA/MOOSE compliant systematic search, Pubmed/PsycInfo, last search June 31 st , 2020 (protocol https://osf.io/b8rvs/), with random-effect meta-analysis of observational studies comparing CVD screening/treatment in people with vs. without mental disorders. Primary outcome was Odds Ratios (ORs) for CVD screening/treatment. Sensitivity analyses on screening/treatment separately, on specific procedures, as well as country/confounding subgroup analyses, and meta-regressions were run. Publication bias and quality (Newcastle-Ottawa Scale (NOS)) were assessed. Results. Forty-seven studies (n=24,400,452, 1,283,602 with mental disorders), from North America (k=26), Europe (k=16), Asia (k=4), and Australia (k=1) were meta-analyzed. Lower rates of screening/treatment in mental disorders emerged for any CVD (k=47, OR=0.773, 95%CI=0.742-0.804, p<0.001), coronary artery disease (k=34, OR=0.734, 95%CI=0.690-0.781, p<0.001), cerebrovascular disease (k=8, OR=0.810, 95%CI=0.779-0.842, p<0.001), or other mixed CVDs (k=11, OR=0.839, 95%CI=0.761-0.924, p<0.001).Significant disparities emerged for any screening, any intervention, catheterization/revascularization in coronary artery disease, intravenous thrombolysis for stroke, and treatment with any and specific medications for CVD across all mental disorders (except for CVD medications in mood disorders). Disparities were largest for schizophrenia, and differed across countries. Median quality was high (NOS=8), higher quality studies found larger disparities, and publication bias did not affect results. Conclusions.People with mental disorders (schizophrenia in particular) receive less screening and lower quality treatment for CVD. It is of paramount importance to address under-prescribing of CVD medications and under-utilization of diagnostic and therapeutic procedures across all mental disorders.

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BackgroundThe transient global cerebral hypoperfusion/reperfusion achieved by induction of Bilateral Common Carotid Artery Occlusion followed by Reperfusion (BCCAO/R) has been shown to stimulate early molecular changes that can be easily traced in brain tissue and plasma, and that are indicative of the tissue physiological response to the reperfusion-induced oxidative stress and inflammation. The aim of the present study is to probe the possibility to prevent the molecular changes induced by the BCCAO/R with dietary natural compounds known to possess anti-inflammatory activity, such as the phytocannabinoid beta-caryophyllene (BCP).MethodsTwo groups of adult Wistar rats were used, sham-operated and submitted to BCCAO/R. In both groups, 6 h before surgery, half of the rats were gavage-fed with a single dose of BCP (40 mg/per rat in 300 μl of sunflower oil as vehicle), while the second half were pre-treated with the vehicle alone. HPLC, Western Blot and immunohistochemistry were used to analyze cerebral cortex and plasma.ResultsAfter BCCAO/R, BCP prevented the increase of lipoperoxides occurring in the vehicle-treated rats in both cerebral cortex and plasma. In the frontal cortex, BCP further prevented activation of the endocannabinoid system (ECS), spared the docosahexaenoic acid (DHA), appeared to prevent the increase of cyclooxygenase-2 and increased the peroxisome-proliferator activated receptor-alpha (PPAR-alpha) protein levels, while, in plasma, BCP induced the reduction of arachidonoylethanolamide (AEA) levels as compared to vehicle-treated rats.ConclusionsCollectively, the pre-treatment with BCP, likely acting as agonist for CB2 and PPAR-alpha receptors, modulates in a beneficial way the ECS activation and the lipoperoxidation, taken as indicative of oxidative stress. Furthermore, our results support the evidence that BCP may be used as a dietary supplement to control the physiological response to the hypoperfusion/reperfusion-induced oxidative stress.