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2型糖尿病和严重精神疾病患者的心血管风险管理:一个队列研究
Jonne G Ter Braake1, Kelly J Fleetwood2, Rimke C Vos1
1Department of Public Health and Primary Care, Leiden University Medical Centre, The Hague, the Netherlands.
Diabetologia
|February 27, 2024
概括
患有严重精神疾病 (SMI) 的人在心血管风险管理方面表现出差异,包括胆固醇目标和他类药物处方,突出了对这一群体进行专注临床审查的需要.
科学领域:
- 心脏病学 心脏病学
- 精神病学是一个精神病学.
- 公共卫生 公共卫生
背景情况:
- 心血管疾病 (CVD) 是全球主要的死亡原因.
- 患有2型糖尿病 (T2D) 的人患心血管疾病的风险较高.
- 严重精神疾病 (SMI) 越来越被认为是影响慢性疾病管理的一个因素.
研究的目的:
- 根据SMI状态,对T2D患者的心血管风险管理进行比较.
- 为了研究实现胆固醇,血压和HbA1c目标的差异.
- 检查与SMI相关的他类药物处方模式.
主要方法:
- 在苏格兰 (2004-2020年) 使用链接的电子健康数据进行了回顾性队列研究.
- 包括291,644名被诊断患有T2D的成年人,从医院记录中确定了SMI史.
- 调整了社会人口统计学和临床因素的后勤回归分析,以比较目标实现和收取他类药物的情况.
主要成果:
- 患有SMI的人不太可能达到胆固醇目标,但更有可能达到静缩血压目标.
- 根据SMI疾病和性别,HbA1c目标的实现有所不同.
- 对于那些没有先前心血管疾病的SMI患者,他类药物处方类似或更好,但对于那些先前心血管疾病和SMI患者来说,处方水平较低.
结论:
- 胆固醇目标的实现和对T2D和SMI患者的他类药物处方存在显著差异.
- 对他类药物处方的临床审查对于二次心血管疾病预防至关重要,特别是在SMI患者中.
- 需要进一步的研究来了解和解决这些管理差距.
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