Luis Ayerbe1, Ivo Forgnone2, Juliet Addo3, Ana Siguero4, Stefano Gelati5, Salma Ayis6. 1. Centre of Primary Care and Public Health, Queen Mary University of London, London, United Kingdom. Electronic address: l.garcia-morzon@qmul.ac.uk. 2. Cerro del Aire Primary Care Centre, Madrid, Spain; Dr Cirajas Primary Care Centre, Madrid, Spain. 3. Department of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom. 4. Dr Cirajas Primary Care Centre, Madrid, Spain. 5. Mental Health Service, South Essex Partnership University NHS Foundation Trust Rochford, United Kingdom. 6. Division of Health and Social care Research, King's College London, London, United Kingdom.
Abstract
BACKGROUND: A higher cardiovascular morbidity and mortality has been observed in patients with bipolar disorder (BPD) or schizophrenia, partly due to an increased risk of hypertension (HTN), or a less effective care of it. This systematic review and meta-analysis, presents a critical appraisal and summary of the studies addressing the risk of HTN, or the differences in its care, for those with schizophrenia or BPD. METHODS: Prospective studies were searched in PubMed, Embase, PsycINFO, Scopus, and the Web of Science, from database inception to June 2017. A meta-analysis was undertaken to obtain pooled estimates of the risk of HTN. RESULTS: Five studies reporting the risk of HTN, and five studies presenting differences in its clinical care, were identified. An increased risk of HTN was observed for BPD patients, with an overall Incidence Rate Ratio 1.27(1.15-1.40). The pooled Incidence Rate Ratio of HTN for those with schizophrenia was 0.94 (0.75 - 1.14). A poorer care of HTN (lower rates of screening, prescription, and adherence) was reported in four studies of schizophrenia, and two of BPD patients, compared to people without these conditions. LIMITATIONS: reduced number of studies on risk and care of HTN on patients with BPD or schizophrenia. CONCLUSIONS: Limited evidence suggests that patients with BPD have a higher risk of HTN. Patients with schizophrenia and BPD receive poor care of HTN. Understanding the risk of HTN, and the differences in its care, is essential for clinicians to reduce the cardiovascular morbidity and overall mortality of these patients.
BACKGROUND: A higher cardiovascular morbidity and mortality has been observed in patients with bipolar disorder (BPD) or schizophrenia, partly due to an increased risk of hypertension (HTN), or a less effective care of it. This systematic review and meta-analysis, presents a critical appraisal and summary of the studies addressing the risk of HTN, or the differences in its care, for those with schizophrenia or BPD. METHODS: Prospective studies were searched in PubMed, Embase, PsycINFO, Scopus, and the Web of Science, from database inception to June 2017. A meta-analysis was undertaken to obtain pooled estimates of the risk of HTN. RESULTS: Five studies reporting the risk of HTN, and five studies presenting differences in its clinical care, were identified. An increased risk of HTN was observed for BPD patients, with an overall Incidence Rate Ratio 1.27(1.15-1.40). The pooled Incidence Rate Ratio of HTN for those with schizophrenia was 0.94 (0.75 - 1.14). A poorer care of HTN (lower rates of screening, prescription, and adherence) was reported in four studies of schizophrenia, and two of BPD patients, compared to people without these conditions. LIMITATIONS: reduced number of studies on risk and care of HTN on patients with BPD or schizophrenia. CONCLUSIONS: Limited evidence suggests that patients with BPD have a higher risk of HTN. Patients with schizophrenia and BPD receive poor care of HTN. Understanding the risk of HTN, and the differences in its care, is essential for clinicians to reduce the cardiovascular morbidity and overall mortality of these patients.
Authors: I H Heiberg; R Nesvåg; L Balteskard; J G Bramness; C M Hultman; Ø Naess; T Reichborn-Kjennerud; E Ystrom; B K Jacobsen; A Høye Journal: Acta Psychiatr Scand Date: 2020-02-29 Impact factor: 6.392
Authors: I H Heiberg; B K Jacobsen; L Balteskard; J G Bramness; Ø Naess; E Ystrom; T Reichborn-Kjennerud; C M Hultman; R Nesvåg; A Høye Journal: Acta Psychiatr Scand Date: 2019-03-29 Impact factor: 6.392
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