Journal article
Screening, Diagnosis, and Treatment of Dyslipidemia Among Persons With Persistent Mental Illness: A Literature Review
Psychiatric services (Washington, D.C.), Vol.63(7), pp.693-701
2012
DOI: 10.1176/appi.ps.201100475
PMID: 22588231
Abstract
Objective: Cardiovascular disease is the most frequent cause of death of persons with severe and persistent mental illness, and there is evidence of a widening mortality gap with the general population. Modifiable risk factors for cardiovascular disease, including dyslipidemia, are frequently underrecognized and undertreated. This review provides practitioners with an update on screening, diagnosis, and referral or treatment of dyslipidemia in this population.
Methods: A literature search in PubMed from 1990 to 2012 that used various combinations of the terms cholesterol, screening, diagnosis, treatment, and severe mental illnesses identified 74 clinically relevant articles for review, and reference lists guided further exploration of sources. Additional material was selected with a focus on emerging guidelines to create clinically relevant recommendations for practitioners.
Results: Multiple barriers can prevent clinicians from obtaining samples from fasting patients, which can be detrimental to successful screening. Dyslipidemia can be successfully screened for with nonfasting total cholesterol, high-density lipoprotein (HDL) cholesterol, and triglycerides, with follow-up measurement of fasting low-density lipoprotein (LDL) cholesterol if total cholesterol is greater than 200 mg/dl or triglycerides are above 500 mg/dl. Compelling evidence supports pharmacologic treatment of dyslipidemia to reduce cardiovascular events among high-risk patients.
Conclusions: When obtaining samples from fasting patients is not feasible, use of samples from nonfasting patients can radically improve management of dyslipidemia among persons with severe and persistent mental illness. Common medications used to treat dyslipidemia are inexpensive, safe, and effective and could be more liberally employed to address comorbidities in this population.
Details
- Title: Subtitle
- Screening, Diagnosis, and Treatment of Dyslipidemia Among Persons With Persistent Mental Illness: A Literature Review
- Creators
- Erik R VANDERLIP - Department of Family Medicine and the Department of Psychiatry, Roy J. and Lucille A. Carver College of Medicine, University of Iowa Hospitals and Clinics, 200 Hawkins Dr., Iowa City, IA 52242, United StatesJess G FIEDOROWICZ - Departments of Psychiatry and Internal Medicine, Roy J. and Lucille A. Carver College of Medicine, University of Iowa Hospitals and Clinics, 200 Hawkins Dr., Iowa City, IA 52242, United StatesWilliam G HAYNES - Department of Internal Medicine, Roy J. and Lucille A. Carver College of Medicine, University of Iowa Hospitals and Clinics, 200 Hawkins Dr., Iowa City, IA 52242, United States
- Resource Type
- Journal article
- Publication Details
- Psychiatric services (Washington, D.C.), Vol.63(7), pp.693-701
- Publisher
- American Psychiatric Association; Arlington, VA
- DOI
- 10.1176/appi.ps.201100475
- PMID
- 22588231
- ISSN
- 1075-2730
- eISSN
- 1557-9700
- Language
- English
- Date published
- 2012
- Academic Unit
- Psychiatry; Epidemiology; Iowa Neuroscience Institute
- Record Identifier
- 9984065396702771
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