TOPLINE:

Among primary care patients with mental illness, more than one third of women and a majority of men demonstrated a moderate or high cardiovascular risk according to Systematic COronary Risk Evaluation 2 (SCORE2). Targeted health dialogues (THDs) revealed additional modifiable lifestyle-related cardiovascular risk factors, including elevated waist-hip ratio (WHR) and physical inactivity.

METHODOLOGY:

• Researchers conducted a cross-sectional study comparing SCORE2 cardiovascular risk assessment with THDs in primary care patients with mental illness.
• They recruited 120 patients aged 40-69 years who were seeking care for mental health issues (depression, anxiety, stress, or insomnia) at six publicly funded primary healthcare centres in Sweden from February 2020 to December 2024.
• During routine consultations, any nurse, physician, or psychologist could invite eligible patients to participate in THDs, which assessed modifiable lifestyle-related cardiovascular risk factors including BMI, WHR, diet quality, physical activity, alcohol consumption, and others.
• SCORE2 was calculated using participants' values for non-high-density lipoprotein cholesterol, systolic blood pressure, smoking status, age, and sex, with risk levels classified as low, moderate, and high.
• The analysis compared cardiovascular risk factors identified through THDs across different SCORE2 risk levels in men (n = 37) and women (n = 76).

TAKEAWAY:

• Among 113 patients aged 40-69 years with complete data, 36% of women and 86% of men demonstrated a moderate or high cardiovascular risk according to SCORE2.
• Among women, tobacco use and total cholesterol levels greater than 5 mmol/L showed a significantly higher distribution in the moderate SCORE2 level group than in the low SCORE2 level group (P = .036 and P = .032, respectively).
• A higher proportion of men with a moderate SCORE2 risk had BMI greater than 25 than those with low and high SCORE2 risks.
• A substantial proportion of patients with a low SCORE2 risk had multiple cardiovascular risk factors identified through THDs, including elevated WHR, low-density lipoprotein cholesterol levels greater than 3.0 mmol/L, and physical inactivity.

IN PRACTICE:

"Targeted Health Dialogues may complement SCORE2 by identifying additional modifiable lifestyle-related risk factors relevant to cardiovascular prevention in patients with mental illness," the authors wrote.

SOURCE:

This study was led by Veronica Milos-Nymberg, University Clinic Primary Care, Skåne University Hospital, Malmö, Sweden. It was published online on May 04, 2026, in PLoS One.

LIMITATIONS:

The sample size of the study was small, especially among men. The study lacked data on participants' socioeconomic status, a factor associated with higher rates of tobacco use, physical inactivity, and poor nutrition. Information regarding behavioural changes or clinical follow-up after the THDs was not collected. SCORE2 validation was restricted to individuals aged 40-69 years, thereby limiting the generalisability of the findings.

DISCLOSURES:

This study received support from the Swedish Research Council and Swedish governmental funding of clinical research (ALF) awarded to one author and funding from Primary Care Skåne (USVE) awarded to another author. The authors reported having no competing interests.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.