精神疾病患者的心血管疾病负担:美国精神病学门诊病人样本与美国普通人群样本的比较

IF 9 Q1 PSYCHIATRY
R. Dhingra, Fan He, Erika F. H. Saunders, Daniel A. Waschbusch, Amanda M. Pearl, E. Bixler, Jody L. Greaney, Alison R. Swigart, Laila Al-Shaar, Vernon M. Chinchilli, J. Yanosky, Duanping Liao
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引用次数: 0

摘要

背景。利用电子健康记录数据,我们描述了 2015 年至 2020 年期间宾夕法尼亚州立精神病学临床评估和分级评价系统 (PCARES) 登记的精神疾病患者的心血管疾病负担。方法。心血管疾病负担评估包括心血管疾病患病率(任何主要心血管疾病或个别心血管疾病危险因素)、针对心血管疾病危险因素的指示药物处方以及体重指数(BMI,kg/m2)、糖化血红蛋白(HbA1C,%)、血糖(mg/dl)和血脂(mg/dl)的平均水平。我们使用比例/均值的单样本卡方/t 检验比较了 PCARES 样本与美国普通人群中具有代表性的成人样本(NHANES 2013-2016)之间的心血管疾病负担。根据 PCARES 的年龄、种族和性别统计数据对 NHANES 参与者的心血管疾病负担进行了调整。结果。PCARES 样本(N=3556)的平均年龄(SE)为 42.4 (0.3)岁,其中 63.0% 为女性,85.0% 为非西班牙裔白种人,41.0% 患有重度抑郁症。与 NHANES 参与者相比,PCARES 样本的心血管疾病负担较重,包括任何主要心血管疾病(8.6% 对 4.6%)、糖尿病(18.4% 对 10.4%)、体重指数(30.3 对 28.3)、血红蛋白 A1C(6.1 对 5.6)、胆固醇(185.6 vs. 181.7)、甘油三酯(153.3 vs. 136.1),以及服用降压药(94.3% vs. 76.9%)和降胆固醇药(49.5% vs. 36.7%)(每项结果的 Bonferroni 校正 p=0.03)。在高血压(45.9% 对 50.4%)、血脂异常(43.2% 对 61.9%)、高密度脂蛋白胆固醇(HDL-C)(48.4 对 41.4)和低密度脂蛋白胆固醇(LDL-C)(107.9 对 112.0)方面,PCARES 样本的心血管疾病负担低于 NHANES 参与者(每项结果的 Bonferroni 校正 p=0.03)。两个样本的血糖水平(110.9 vs. 111.9)和指示服用的抗糖尿病药物(87.4% vs. 86.6%)相似(P>0.05)。结论与美国普通人群相比,精神疾病患者的心血管疾病负担更高。精神和身体综合保健服务可以减少精神病患者的长期残疾。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Cardiovascular Disease Burden in Persons with Mental Illness: Comparison between a U.S. Psychiatry Outpatient Sample and a U.S. General Population Sample
Background. Cardiovascular disease (CVD) and depression are the leading causes of disability in the U.S. Using electronic health record data, we describe the CVD burden among persons with mental illness enrolled in the Penn State Psychiatry Clinical Assessment and Rating Evaluation System (PCARES) Registry between 2015 and 2020. Methods. CVD burden assessment included prevalence of CVD conditions (any major CVD or individual CVD risk factors), indicated medication prescriptions for CVD risk factors, and mean levels of body mass index (BMI, kg/m2), glycosylated hemoglobin (HbA1C, %), glucose (mg/dl), and lipids (mg/dl). We compared the CVD burden between the PCARES sample to a representative sample of adults from the U.S. general population (NHANES 2013-2016) using one-sample chi-square/t-tests for proportions/means. The CVD burden in NHANES participants was adjusted to PCARES age, race, and sex statistics. Results. The PCARES sample (N=3556) had a mean (SE) age of 42.4 (0.3) years and comprised 63.0% women, 85.0% non-Hispanic Caucasians, and 41.0% with major depressive disorder. CVD burden was higher in the PCARES sample compared to NHANES participants for any major CVD (8.6% vs. 4.6%), diabetes (18.4% vs. 10.4%), BMI (30.3 vs. 28.3), HbA1C (6.1 vs. 5.6), cholesterol (185.6 vs. 181.7), triglycerides (153.3 vs. 136.1), and indicated antihypertensive (94.3% vs. 76.9%) and cholesterol-lowering (49.5% vs. 36.7%) medications (Bonferroni-corrected p=0.03 for each outcome). The CVD burden was lower in the PCARES sample compared to NHANES participants for hypertension (45.9% vs. 50.4%), dyslipidemia (43.2% vs. 61.9%), HDL-C (48.4 vs. 41.4), and LDL-C (107.9 vs. 112.0) (Bonferroni-corrected p=0.03 for each outcome). Glucose levels (110.9 vs. 111.9) and indicated antidiabetic medications (87.4% vs. 86.6%) were similar in the two samples (p>0.05). Conclusions. The CVD burden was higher in persons with mental illness compared to the U.S. general population. Integrated mental and physical healthcare services could reduce long-term disability among persons with mental illness.
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Mental Illness
Mental Illness PSYCHIATRY-
CiteScore
1.10
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3
审稿时长
10 weeks
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