a Departamento de Medicina , Universitat Autònoma de Barcelona , Cerdanyola del Vallès, Barcelona, Spain.
b Médico de familia , CS Cox /Callosa de Segura , Alicante , Spain.
Clin Exp Hypertens. 2017;39(5):441-447. doi: 10.1080/10641963.2016.1267200. Epub 2017 Jun 7.
Many studies have previously shown increased cardiovascular risk factors related to schizophrenia independently from the use of antipsychotic drugs. However, a poorer effort in clinical detection and management of cardiovascular risk in patients with severe mental illness could also explain these results. To test this hypothesis, we analyzed the differences in screening and incidence of cardiovascular risk factors between schizophrenia, non-schizophrenic patients on treatment with antipsychotic drugs (NS-TAD) and the general population. Data from adult subjects assessed by high-quality register general practitioners from 2006 to 2011 were extracted from the Catalonian SIDIAP database. The schizophrenia, NS-TAD, and control groups were compared in terms of measurements and incidence of diabetes, dyslipidemia, obesity, hypertension, and smoking. A total of 4911 patients in the schizophrenia group, 4157 in NS-TAD group, and 98644 in the control group were included. Schizophrenia patients were screened for dyslipidemia and diabetes more frequently than the control group, while for obesity or hypertension, they were screened equal to controls. Also, as compared to the control group, the NS-TAD group was more frequently screened for obesity with no differences in dyslipidemia and diabetes and less frequently for hypertension. Smoking was less frequently screened in both study groups. The incidence of all risk factors studied in both study groups was higher than or equal to the control group, except for hypertension, which had lower incidence. The lack of screening of risk factors does not appear decisive in the increased cardiovascular risk of patients diagnosed with schizophrenia seen in primary care. Studies evaluating the possible under diagnosis of the risk factors are required.
Schizophrenia (SZ); Treatment with antipsychotic drugs (TAD); Cardiovascular risk factor/s (CVRF); Without schizophrenia but on therapy with antipsychotic drugs (NS-TAD); Defined Daily Dose (DDD).
先前有许多研究表明，与抗精神病药物的使用无关，精神分裂症患者的心血管风险因素增加。然而，严重精神疾病患者的心血管风险的临床检测和管理方面的努力不足，也可能解释这些结果。为了验证这一假说，我们分析了精神分裂症患者、使用抗精神病药物治疗的非精神分裂症患者（NS-TAD）与一般人群之间心血管风险因素筛查和发生率的差异。从 2006 年至 2011 年，高质量登记的全科医生评估的成年患者的数据从加泰罗尼亚 SIDIAP 数据库中提取出来。比较了精神分裂症组、NS-TAD 组和对照组在糖尿病、血脂异常、肥胖、高血压和吸烟方面的测量和发生率。共纳入 4911 例精神分裂症患者、4157 例 NS-TAD 患者和 98644 例对照组。与对照组相比，精神分裂症患者更频繁地筛查血脂异常和糖尿病，但肥胖或高血压的筛查频率与对照组相同。此外，与对照组相比，NS-TAD 组更频繁地筛查肥胖症，而血脂异常和糖尿病的筛查频率没有差异，高血压的筛查频率较低。两组患者的吸烟筛查频率均较低。两组研究对象的所有研究风险因素的发生率均高于或等于对照组，除了高血压的发生率较低。在初级保健中，诊断为精神分裂症的患者的心血管风险增加，这似乎并非归因于风险因素的筛查不足。需要评估评估这些风险因素可能被漏诊的研究。
精神分裂症（SZ）；抗精神病药物治疗（TAD）；心血管风险因素（CVRF）；无精神分裂症但使用抗精神病药物治疗（NS-TAD）；定义日剂量（DDD）。
