Abstract
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Cardiovascular
disease (CVD) is the leading cause of death amongst people with severe mental
illness (SMI) and drives substantial portion of the 15-20 year deficit in
life expectancy experienced by this group relative to the general population.
Statins form a core part of CVD prevention in the general population, but the
evidence-base for people with SMI is unclear. Evidence on the effectiveness
of statins for primary prevention of CVD was systematically searched but did
not identify any studies investigating CVD events or associated mortality in
people with SMI; therefore highlighting the need for studies on the long term
impacts of statin prescribing. Two analytical studies were undertaken using
longitudinal data from The Health Improvement Network (THIN) primary care
database to investigate: 1) CVD screening and statin prescribing in people
with and without SMI and 2) to explore the effectiveness of statins for CVD
prevention in individuals with SMI. Collectively the work has established
that CVD screening and statin prescribing is increasingly accessed by
individuals with SMI at levels that are comparable to people without similar
mental health conditions. The results from this study provide the first
evidence that statin prescribing to people with SMI is associated with
statistically significant reductions in total cholesterol (of 1.2mmol/L for
up to 2 years, p<0.001). There were small non-significant reductions in
the rate of combined MI and stroke (0.89; 95% CI; 0.68-1.15) and all-cause
mortality 0.89 (95% CI; 0.78, 1.02). This study provides evidence that statin
prescribing to people with SMI may have a magnitude of effectiveness that is
broadly similar to the general population.
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