open access publication

Article, 2023

Management of dyslipidaemia in individuals with severe mental illness: a population-based study in the Greater Copenhagen Area

Therapeutic Advances in Psychopharmacology, ISSN 2045-1253, 2045-1261, Volume 13, Page 20451253231211574, 10.1177/20451253231211574

Contributors

Mohr, Grimur Høgnason 0000-0002-2203-2279 (Corresponding author) [1] Barcella, Carlo Alberto [2] [3] Grand, Mia Klinten [3] Kriegbaum, Margit 0000-0001-9078-1194 [3] Siersma, Volkert Dirk 0000-0003-1941-2681 [3] Hahn, Margaret Karolina 0000-0001-8884-9946 [1] [4] [5] Agarwal, Sri Mahavir 0000-0002-2705-5146 [4] [5] Bakkedal, Catrine 0000-0002-2666-4425 [3] Baandrup, Lone 0000-0003-1662-2720 [1] [3] [6] Knop, Filip Krag K 0000-0002-2495-5034 [3] [7] [8] Andersen, Christen Bertel Lykkegaard 0000-0001-7753-6768 [3] [9] Ebdrup, Bjørn Hylsebeck 0000-0002-2590-5055 [1] [3]

Affiliations

  1. [1] Glostrup Hospital
    2. [NORA names: Capital Region of Denmark; Hospital; Denmark; Europe, EU; Nordic; OECD];
  2. [2] Department of Internal Medicine, Nykøbing Falster Hospital, Nykøbing Falster, Denmark
    3. [NORA names: Miscellaneous; Denmark; Europe, EU; Nordic; OECD];
  3. [3] University of Copenhagen
    4. [NORA names: KU University of Copenhagen; University; Denmark; Europe, EU; Nordic; OECD];
  4. [4] Centre for Addiction and Mental Health
    5. [NORA names: Canada; America, North; OECD];
  5. [5] University of Toronto
    6. [NORA names: Canada; America, North; OECD];

Abstract

Background: Severe mental illness (SMI) is associated with increased cardiovascular risk. Dyslipidaemia is a potentially modifiable risk factor, which may be inadequately managed in patients with SMI. Objectives: To assess management of dyslipidaemia in patients with SMI versus healthy controls (HCs) in 2005 and 2015. Design and methods: Using Danish registers, we identified adult patients with SMI in the Greater Copenhagen Area (schizophrenia spectrum disorders or bipolar disorder) with ⩾1 general practitioner contact in the year before 2005 and 2015, respectively, and HCs without SMI matched on age and gender (1:5). Outcomes were lipid-profile measurements, presence of dyslipidaemia and redemption of lipid-lowering pharmacotherapy. Differences in outcomes between patients with SMI and controls were measured with multivariable logistic regression. Results: We identified 7217 patients with SMI in 2005 and 9939 in 2015. After 10 years, patients went from having lower odds of lipid measurements to having higher odds of lipid measurements compared with HCs [odds ratio (OR)2005 0.70 (99% confidence interval (CI) 0.63-0.78) versus OR2015 1.34 (99% CI 1.24-1.44); p2005versus2015 < 0.01]. Patients had higher odds of dyslipidaemia during both years [OR2005 1.43 (99% CI 1.10-1.85) and OR2015 1.23 (99% CI 1.08-1.41)]. Patients went from having lower odds of receiving lipid-lowering pharmacotherapy to having higher odds of receiving lipid-lowering pharmacotherapy [OR2005 0.77 (99% CI 0.66-0.89) versus OR2015 1.37 (99% CI 1.24-1.51); p2005versus2015 < 0.01]. However, among persons at high cardiovascular risk, patients had lower odds of receiving lipid-lowering pharmacotherapy during both years, including subsets with previous acute coronary syndrome [OR2005 0.30 (99% CI 0.15-0.59) and OR2015 0.44 (99% CI 0.24-0.83)] and ischaemic stroke or transient ischaemic attack (TIA) [OR2005 0.43 (99% CI 0.26-0.69) and OR 2015 0.61 (99% CI 0.41-0.89)]. Conclusion: These results imply an increased general awareness of managing dyslipidaemia among patients with SMI in the primary prophylaxis of cardiovascular disease. However, secondary prevention with lipid-lowering drugs in patients with SMI at high cardiovascular risk may be lacking.

Keywords

Copenhagen area, Danish registers, Greater, Greater Copenhagen area, acute coronary syndrome, adult patients, age, area, assess management, associated with increased cardiovascular risk, attacks, cardiovascular disease, cardiovascular risk, contact, control, coronary syndrome, design, differences, disease, drug, dyslipidaemia, factors, gender, general practitioner contacts, healthy controls, identified adult patients, illness, increased general awareness, individuals, ischaemic attack, ischaemic stroke, lipid measurements, lipid profile measurements, lipid-lowering drugs, lipid-lowering pharmacotherapy, logistic regression, management, management of dyslipidaemia, measurements, mental illness, method, modifiable risk factors, multivariate logistic regression, odds, outcomes, patients, persons, pharmacotherapy, population-based study, practitioner contacts, presence, presence of dyslipidaemia, prevention, primary prophylaxis, prophylaxis of cardiovascular diseases, redemption, register, regression, results, risk, risk factors, secondary prevention, severe mental illness, stroke, study, subsets, syndrome, transient ischaemic attack, years

Funders

  • Novo Nordisk Foundation

Data Provider: Digital Science

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