Does having schizophrenia increase the risk of heart problems like high heart rate?
Research shows that people with schizophrenia tend to have a higher resting heart rate and changes in heart electrical activity that can raise the risk of serious heart rhythm problems. A large meta-analysis found that, on average, people with schizophrenia have a heart rate about 6 beats per minute faster than healthy controls 2. They also have greater QT dispersion, a measure of uneven heart repolarization that can lead to dangerous arrhythmias 2. These heart changes are not fully explained by lifestyle factors or other heart disease risks, suggesting schizophrenia itself may affect the heart.
What the research says
A 2025 meta-analysis of 11 studies including over 5,600 people with schizophrenia and over 23,000 healthy controls found that those with schizophrenia had a significantly higher heart rate (average difference of 6.24 beats per minute) 2. The same analysis also found increased QT dispersion (13 ms) and QTc dispersion (21 ms), which are markers of abnormal heart electrical activity that can increase the risk of sudden cardiac death 2. Importantly, these differences were seen even after accounting for medication use, as the analysis included both drug-naïve and medicated patients 2.
Some antipsychotic medications can also affect heart rate and rhythm. For example, risperidone (marketed as Perseris) is an atypical antipsychotic used for schizophrenia 1. While the meta-analysis did not focus on specific drugs, it is known that some antipsychotics can prolong the QT interval or increase heart rate 2. However, the elevated heart rate and dispersion measures in schizophrenia appear to be partly independent of medication effects 2.
Other heart-related risks are also higher in schizophrenia. A separate meta-analysis found that people with schizophrenia have a high prevalence of covert cerebrovascular changes, such as brain atrophy (34.8%) and white matter hyperintensities (26.3%), which are linked to small vessel disease and can increase stroke risk 7. Additionally, diabetes, which is more common in schizophrenia, is associated with cognitive impairment and likely contributes to overall cardiovascular risk 8.
What to ask your doctor
- Should I have an electrocardiogram (ECG) to check my heart rate and rhythm?
- Do my current antipsychotic medications affect my heart rate or QT interval?
- What can I do to lower my risk of heart problems, such as managing weight, blood sugar, and blood pressure?
- Are there any medications, like GLP-1 receptor agonists, that could help with weight and metabolic health while I take antipsychotics?
- How often should I have my heart health monitored given my schizophrenia diagnosis?
This question is drawn from common patient questions about Cardiology and answered using cited medical research. We do not provide individualized advice.