年轻人严重精神疾病 30 年心血管疾病风险。
30-year Cardiovascular Disease Risk for Young Adults with Serious Mental Illness.
机构信息
HealthPartners Institute. 8170 33 Ave S., Minneapolis, Minnesota 55425, USA.
University of Minnesota Medical School. 420 Delaware St SE, Minneapolis, Minnesota, 55455, USA.
出版信息
Gen Hosp Psychiatry. 2023 Nov-Dec;85:139-147. doi: 10.1016/j.genhosppsych.2023.10.015. Epub 2023 Oct 21.
OBJECTIVE
To estimate 30-year CVD risk and modifiable risk factors in young adults with serious mental illness (SMI) versus those without, and assess variations in CVD risk by race, ethnicity, and sex.
METHOD
In this cross-sectional study, we estimated and compared the Framingham 30-year CVD risk score and individual modifiable CVD risk factors in young adult (20-39 years) primary care patients with and without SMI at two US healthcare systems (January 2016-Septemeber 2018). Interaction terms assessed whether the SMI-risk association differed across demographic groups.
RESULTS
Covariate-adjusted 30-year CVD risk was significantly higher for those with (n=4228) versus those without (n=155,363) SMI (RR 1.28, 95% CI [1.26, 1.30]). Patients with SMI had higher rates of hypertension (OR 2.02 [1.7, 2.39]), diabetes (OR 3.14 [2.59, 3.82]), obesity (OR 1.93 [1.8, 2.07]), and smoking (OR 4.94 [4.6, 5.36]). The increased 30-year CVD risk associated with SMI varied significantly by race and sex: there was an 8% higher risk in Black compared to White patients (RR 1.08, [1.04, 1.12]) and a 9% lower risk in men compared to women (RR 0.91 [0.88, 0.94]).
CONCLUSIONS
Young adults with SMI are at increased 30-year risk of CVD, and further disparities exist for Black individuals and women.
目的
评估患有严重精神疾病（SMI）的年轻成年人与无 SMI 的年轻成年人的 30 年 CVD 风险和可改变的危险因素，并评估 CVD 风险在种族、民族和性别方面的差异。
方法
在这项横断面研究中，我们在两个美国医疗保健系统中（2016 年 1 月至 2018 年 9 月），评估并比较了患有和不患有 SMI 的年轻成年人（20-39 岁）初级保健患者的 Framingham 30 年 CVD 风险评分和个体可改变的 CVD 危险因素。交互项评估了 SMI 风险关联是否在不同的人群中存在差异。
结果
校正协变量后，患有 SMI（n=4228）的患者与无 SMI（n=155363）的患者相比，30 年 CVD 风险显著升高（RR 1.28，95%CI[1.26，1.30]）。患有 SMI 的患者高血压（OR 2.02 [1.7，2.39]）、糖尿病（OR 3.14 [2.59，3.82]）、肥胖（OR 1.93 [1.8，2.07]）和吸烟（OR 4.94 [4.6，5.36]）的比例较高。与 SMI 相关的增加 30 年 CVD 风险在种族和性别方面存在显著差异：与白人患者相比，黑人患者的风险增加了 8%（RR 1.08，[1.04，1.12]），而男性患者的风险比女性患者低 9%（RR 0.91 [0.88，0.94]）。
结论
患有 SMI 的年轻成年人患 CVD 的 30 年风险增加，并且在黑人和女性中存在进一步的差异。
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