TY - JOUR
T1 - 30-year cardiovascular disease risk for young adults with serious mental illness
AU - Miley, Kathleen M.
AU - Hooker, Stephanie A.
AU - Crain, A. Lauren
AU - O'Connor, Patrick J.
AU - Haapala, Jacob L.
AU - Bond, David J.
AU - Rossom, Rebecca C.
N1 - Publisher Copyright:
© 2023 Elsevier Inc.
PY - 2023/11/1
Y1 - 2023/11/1
N2 - 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.
AB - 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.
KW - Bipolar disorder
KW - Cardiometabolic disorders
KW - Health disparities
KW - Schizoaffective disorder
KW - Schizophrenia
UR - http://www.scopus.com/inward/record.url?scp=85175474930&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85175474930&partnerID=8YFLogxK
U2 - 10.1016/j.genhosppsych.2023.10.015
DO - 10.1016/j.genhosppsych.2023.10.015
M3 - Article
C2 - 38487652
AN - SCOPUS:85175474930
SN - 0163-8343
VL - 85
SP - 139
EP - 147
JO - General Hospital Psychiatry
JF - General Hospital Psychiatry
ER -