Psychiatric Disease and Hypercholesterolemia in an Urban Academic Primary Care Clinic

Background: There are limited data regarding the quality of cardiovascular risk reduction in primary care settings with a high prevalence of psychiatric disease.

Objective: To determine if there are differences in the rates of testing and treatment for hypercholesterolemia between patients with and without psychiatric disease.

Study Design: Cross-sectional chart review.

Patients: 197 adult patients of a hospital-based, academic primary care clinic.

Method: Medical records were reviewed for demographic information, documented psychiatric disease, cardiovascular risk factors, prescription for cholesterol-lowering medication, and a serum total cholesterol result within 5 years of the most recent clinic visit.

Results: Subjects with (N = 76) and without (N = 121) psychiatric disease had similar clinical and demographic characteristics (all p > .05) as well as rates of cholesterol testing (92% vs. 93%, p = .91). Neither diagnosis of hypercholesterolemia nor prescription for cholesterol-lowering medication were associated with psychiatric disease (p = 1.00 and p = .34, respectively). The mean serum total cholesterol was 15 mg/dL higher for patients with psychiatric disease than for those without (p = .016).

Conclusion: In this patient population, the presence of psychiatric disease was not associated with differential rates of hypercholesterolemia testing, diagnosis, or treatment. We observed higher mean serum total cholesterol levels in subjects with psychiatric disease. Further study is needed to examine the implications of our findings.