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Hypertension risk and clinical care in patients with bipolar disorder or schizophrenia:a systematic review and meta-analysis

机译：躁郁症或精神分裂症患者的高血压风险和临床护理：系统评价和荟萃分析

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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.
机译：背景：双相情感障碍（BPD）或精神分裂症患者的心血管疾病发病率和死亡率较高，部分原因是高血压（HTN）风险增加或对其进行的无效护理。这项系统的审查和荟萃分析，对患有精神分裂症或BPD的HTN风险或其护理差异的研究进行了重要的评估和总结。方法：从数据库开始到2017年6月，在PubMed，Embase，PsycINFO，Scopus和Web of Science中搜索前瞻性研究。进行荟萃分析，以收集HTN风险的汇总估计。结果：确定了5项报告HTN风险的研究，以及5项报告其临床护理差异的研究。 BPD患者的HTN风险增加，总发生率比为1.27（1.15-1.40）。精神分裂症患者的HTN合并发病率比为0.94（0.75 – 1.14）。与没有这些疾病的人相比，在四项精神分裂症研究和两名BPD患者中报告了对HTN的护理较差（筛查，处方和依从性较低）。局限性减少了对BPD或精神分裂症患者HTN风险和护理的研究数量。结论：有限的证据表明BPD患者的HTN风险较高。患有精神分裂症和BPD的患者对HTN的护理较差。了解HTN的风险及其护理的差异，对于临床医生降低这些患者的心血管疾病发病率和总体死亡率至关重要。

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