Table 1. Patient Characteristics and CV Risk at Index Visit by System and Treatment Group.
| Characteristic | All | Site A | Site B | Site C | ||||
|---|---|---|---|---|---|---|---|---|
| Control | CDS | Control | CDS | Control | CDS | Control | CDS | |
| No. | 4387 | 4550 | 2120 | 1807 | 1486 | 1818 | 781 | 925 |
| Women, No. (%) | 2392 (54.5) | 2530 (55.6) | 1157 (54.6) | 962 (53.2) | 797 (53.6) | 1040 (57.2) | 438 (56.1) | 528 (57.1) |
| Age, mean (SD), y | 48.1 (13.4) | 48.6 (13.3) | 47.8 (13.6) | 47.3 (13.2) | 47.8 (13.1) | 48.3 (13.3) | 49.6 (13.6) | 52.0 (13.0) |
| Age group, No. (%) | ||||||||
| 18-39 y | 1265 (28.8) | 1270 (27.9) | 632 (29.8) | 553 (30.6) | 434 (29.2) | 527 (29.0) | 199 (25.5) | 190 (20.5) |
| 40-49 y | 961 (21.9) | 962 (21.1) | 472 (22.3) | 400 (22.1) | 325 (21.9) | 397 (21.8) | 164 (21.0) | 165 (17.8) |
| 50-59 y | 1194 (27.3) | 1263 (27.8) | 550 (25.9) | 515 (28.5) | 418 (28.1) | 483 (26.6) | 226 (28.9) | 265 (28.6) |
| 60-64 y | 462 (10.5) | 493 (10.8) | 220 (10.4) | 163 (9.0) | 161 (10.8) | 194 (10.7) | 81 (10.4) | 136 (14.7) |
| 65-75 y | 505 (11.5) | 562 (12.4) | 246 (11.6) | 176 (9.7) | 148 (10.0) | 217 (11.9) | 111 (14.2) | 169 (18.3) |
| Race and ethnicity, No. (%) | ||||||||
| Asian | 55 (1.3) | 76 (1.7) | 35 (1.7) | 52 (2.9) | 8 (0.5) | 10 (0.6) | 12 (1.5) | 14 (1.5) |
| Black | 390 (8.9) | 515 (11.3) | 287 (13.5) | 329 (18.2) | 39 (2.6) | 73 (4.0) | 64 (8.2) | 113 (12.2) |
| Hispanic | 72 (1.6) | 53 (1.2) | 53 (2.5) | 31 (1.7) | 6 (0.4) | 11 (0.6) | 13 (1.7) | 11 (1.2) |
| Native American | 69 (1.6) | 113 (2.5) | 19 (0.9) | 15 (0.8) | 41 (2.6) | 98 (5.4) | 9 (1.2) | 0 |
| White | 3740 (85.3) | 3743 (82.3) | 1691 (79.8) | 1361 (75.3) | 1386 (93.3) | 1614 (88.8) | 663 (84.9) | 768 (83.0) |
| Other or unknowna | 133 (3.0) | 103 (2.3) | 88 (4.2) | 50 (2.8) | 12 (2.8) | 23 (1.3) | 33 (4.2) | 30 (3.2) |
| SMI subgroup, No. (%) | ||||||||
| Schizoaffective | 864 (19.7) | 883 (19.4) | 413 (19.5) | 382 (21.1) | 296 (19.9) | 295 (16.2) | 155 (19.8) | 206 (22.3) |
| Schizophrenia | 657 (15.0) | 632 (13.9) | 234 (11.0) | 262 (14.5) | 297 (20.0) | 245 (13.5) | 126 (16.1) | 125 (13.5) |
| Bipolar | 2866 (65.3) | 3035 (66.7) | 1473 (69.5) | 1163 (64.4) | 893 (60.1) | 1278 (70.3) | 500 (64.0) | 594 (64.2) |
| ACC/AHA 10-y CV risk | ||||||||
| No. | 3586 | 3708 | 1744 | 1500 | 1168 | 1377 | 674 | 831 |
| Mean (SD) | 8.1 (8.7) | 8.5 (8.9) | 7.8 (8.6) | 8.1 (8.7) | 8.6 (8.6) | 8.5 (8.8) | 8.2 (8.9) | 9.1 (9.6) |
| 25th Percentile | 2.3 | 2.4 | 2 | 2.3 | 2.6 | 2.5 | 2.4 | 2.4 |
| Median | 5.2 | 5.4 | 4.8 | 5.2 | 5.9 | 5.5 | 5.1 | 5.8 |
| 75th Percentile | 11.1 | 11.5 | 10.2 | 10.7 | 11.7 | 11.4 | 11.4 | 12.7 |
| Aged >39 y with no CHD | ||||||||
| No. | 2569 | 2704 | 1221 | 1059 | 845 | 994 | 503 | 651 |
| Mean (SD) | 9.1 (8.7) | 9.5 (9.1) | 8.8 (8.7) | 9.3 (9.1) | 9.5 (8.7) | 9.3 (8.7) | 8.9 (8.7) | 10.1 (9.9) |
| 25th Percentile | 3.0 | 3.2 | 2.6 | 3.1 | 3.4 | 3.2 | 2.8 | 3.3 |
| Median | 6.3 | 6.5 | 6.1 | 6.5 | 7.1 | 6.4 | 5.9 | 6.8 |
| 75th Percentile | 12.5 | 12.7 | 12.1 | 12.4 | 13 | 12.3 | 12.6 | 13.5 |
| Framingham 10-y CV risk | ||||||||
| No. | 4387 | 4550 | 2120 | 1807 | 1486 | 1818 | 781 | 925 |
| Mean (SD) | 7.1 (8.1) | 7.3 (8.2) | 6.7 (7.8) | 6.9 (8.0) | 7.7 (8.5) | 7.4 (8.2) | 7.3 (8.2) | 8 (8.7) |
| 25th Percentile | 1.8 | 1.9 | 1.7 | 1.6 | 2.1 | 2.0 | 1.9 | 2.0 |
| Median | 4.0 | 4.1 | 3.7 | 3.8 | 4.5 | 4.1 | 4.1 | 4.7 |
| 75th Percentile | 9.1 | 9.9 | 8.3 | 9.0 | 10.1 | 9.9 | 9.7 | 11.1 |
| Aged >39 y with no CHD | ||||||||
| No. | 2925 | 3077 | 1395 | 1184 | 984 | 1194 | 546 | 699 |
| Mean (SD) | 8.6 (8.6) | 8.8 (8.6) | 8.1 (8.3) | 8.5 (8.6) | 9.3 (9.0) | 8.8 (8.4) | 8.4 (8.4) | 9.2 (8.9) |
| 25th Percentile | 2.6 | 2.7 | 2.4 | 2.5 | 3.0 | 2.8 | 2.5 | 2.8 |
| Median | 5.6 | 5.7 | 5.1 | 5.6 | 6.4 | 5.7 | 5.4 | 6.1 |
| 75th Percentile | 11.6 | 12.1 | 10.9 | 11.3 | 12.6 | 12.4 | 11.3 | 12.9 |
| Modifiable CV risk | ||||||||
| Mean (SD) | 3.6 (5.5) | 3.7 (5.7) | 3.4 (5.6) | 3.6 (5.5) | 4.1 (5.6) | 3.9 (5.8) | 3.3 (5) | 3.4 (5.5) |
| 25th Percentile | 0.3 | 0.3 | 0.3 | 0.3 | 0.5 | 0.5 | 0.3 | 0.3 |
| Median | 1.6 | 1.6 | 1.4 | 1.5 | 2.1 | 2.0 | 1.4 | 1.3 |
| 75th Percentile | 4.3 | 4.3 | 3.9 | 4.3 | 5.1 | 4.4 | 3.9 | 4.1 |
| 30-y (Lifetime) CV risk | ||||||||
| Aged <60 y, No. | 2685 | 2733 | 1310 | 1181 | 884 | 1011 | 491 | 541 |
| Risk factors, % | ||||||||
| All optimal | 2.5 | 2.5 | 2.6 | 2.7 | 2.1 | 2.4 | 2.9 | 2.4 |
| ≥1 Not optimal | 7.5 | 7.4 | 9.2 | 7.5 | 4.9 | 6.8 | 7.7 | 8.5 |
| ≥1 Elevated | 3.9 | 3.8 | 4.5 | 3.6 | 3.5 | 3.5 | 3.3 | 5.2 |
| 1 Major | 46.3 | 46.3 | 48.9 | 46.7 | 41.9 | 44.3 | 47.3 | 45.3 |
| ≥2 Major | 39.8 | 40.7 | 34.8 | 39.5 | 47.6 | 43.0 | 38.9 | 38.6 |
| Aged <60 y with no CHD, No. | 2585 | 2627 | 1262 | 1140 | 847 | 963 | 476 | 524 |
| Risk factors, % | ||||||||
| All optimal | 2.6 | 2.6 | 2.7 | 2.8 | 2.2 | 2.5 | 2.9 | 2.5 |
| ≥1 Not optimal | 7.7 | 7.6 | 9.4 | 7.7 | 5 | 7 | 8 | 8.6 |
| ≥1 Elevated | 4.1 | 4.0 | 4.7 | 3.7 | 3.7 | 3.6 | 3.4 | 5.3 |
| 1 Major | 46.9 | 46.2 | 49.5 | 47.6 | 42.5 | 44.9 | 47.9 | 45.6 |
| ≥2 Major | 38.7 | 39.6 | 33.7 | 38.2 | 46.6 | 42.1 | 37.8 | 38 |
| Current smoking, No. (%) | 2027 (46.2) | 2131 (46.8) | 930 (43.9) | 840 (46.5) | 782 (52.6) | 982 (54.0) | 315 (40.3) | 309 (33.4) |
| Body mass indexb | ||||||||
| Mean (SD) | 32.8 (8.0) | 32.6 (7.8) | 32.6 (7.9) | 32.2 (7.6) | 32.8 (7.9) | 32.7 (8.1) | 32.9 (8.3) | 32.8 (7.6) |
| 25th Percentile | 27.3 | 27.2 | 27.4 | 27 | 27.2 | 27.2 | 27.4 | 27.3 |
| Median | 31.6 | 31.5 | 31.4 | 31.4 | 31.9 | 31.6 | 31.4 | 31.5 |
| 75th Percentile | 36.9 | 36.8 | 36.6 | 36.4 | 37.1 | 36.9 | 37.3 | 37.2 |
| Systolic blood pressure, mm Hg | ||||||||
| Mean (SD) | 124.2 (16.5) | 124.4 (16.6) | 123.9 (16.7) | 124.6 (17.2) | 125.1 (16.6) | 124.4 (16.1) | 123.2 (15.9) | 124.3 (16.5) |
| 25th Percentile | 112 | 113 | 112 | 113 | 114 | 114 | 111 | 112 |
| Median | 123 | 124 | 123 | 124 | 123 | 124 | 122 | 123 |
| 75th Percentile | 134 | 134 | 133 | 135 | 135 | 134 | 132 | 134 |
| Diastolic blood pressure, mm Hg | ||||||||
| Mean (SD) | 78.3 (11.4) | 78.3 (11.4) | 79.0 (11.7) | 79.9 (11.9) | 77.9 (10.8) | 77.7 (10.5) | 77.0 (11.5) | 76.5 (11.8) |
| 25th Percentile | 70 | 70 | 71 | 72 | 70 | 71 | 70 | 69 |
| Median | 78 | 78 | 79 | 80 | 78 | 78 | 76 | 76 |
| 75th Percentile | 85 | 86 | 86 | 87 | 84 | 84 | 84 | 84 |
| Blood pressure <140/90 mm Hg, No. (%) | 3712 (84.6) | 3816 (83.9) | 1744 (82.3) | 1417 (78.4) | 1296 (87.2) | 1590 (87.5) | 672 (86.0) | 809 (87.5) |
| LDL-C, mg/dL | ||||||||
| Mean (SD) | 104.6 (35.6) | 104.9 (35.4) | 104.3 (34.8) | 102.1 (34.4) | 105.3 (36.8) | 106.9 (36.3) | 104.1 (35.7) | 106.7 (35.4) |
| 25th Percentile | 80 | 80 | 80 | 78 | 79 | 81 | 79 | 81 |
| Median | 102 | 103 | 102 | 100 | 102 | 104 | 101 | 104 |
| 75th Percentile | 126 | 126 | 126 | 122 | 128 | 130 | 126 | 127 |
| HbA1c among those with diabetes | ||||||||
| No. | 866 | 947 | 375 | 376 | 309 | 337 | 182 | 234 |
| Mean (SD) | 7.3 (1.8) | 7.1 (1.7) | 7.4 (1.9) | 7.2 (1.6) | 7.2 (1.7) | 7.1 (1.6) | 7.4 (1.9) | 7.1 (1.7) |
| 25th Percentile | 6.1 | 6.0 | 6.1 | 6.1 | 6.1 | 6.0 | 6.2 | 6.0 |
| Median | 6.9 | 6.7 | 6.9 | 6.8 | 6.8 | 6.7 | 6.9 | 6.6 |
| 75th Percentile | 7.9 | 7.7 | 7.9 | 7.9 | 7.8 | 7.6 | 8.3 | 7.6 |
| HbA1c, No. (%) | ||||||||
| <7% | 464 (53.6) | 546 (57.7) | 191 (50.9) | 206 (54.8) | 177 (57.3) | 201 (59.6) | 96 (52.7) | 139 (59.4) |
| 7% to <8% | 186 (21.5) | 205 (21.6) | 91 (24.3) | 81 (21.5) | 59 (19.1) | 71 (21.1) | 36 (19.8) | 53 (22.6) |
| 8% to <9% | 83 (9.6) | 63 (6.7) | 37 (9.9) | 28 (7.4) | 28 (9.1) | 20 (5.9) | 18 (9.9) | 15 (6.4) |
| ≥9% | 133 (15.4) | 133 (14.0) | 56 (14.9) | 61 (16.2) | 45 (14.6) | 45 (13.4) | 32 (17.6) | 27 (11.5) |
Abbreviations: ACC/AHA, American College of Cardiology/American Heart Association; CDS, clinical decision support; CHD, coronary heart disease; CV, cardiovascular; HbA1c, hemoglobin A1c; LDL-C, low-density lipoprotein cholesterol; SMI, serious mental illness.
SI conversion factors: To convert LDL-C to millimoles per liter, multiply by 0.0259; and HbA1c to proportion of total hemoglobin, multiply by 0.01.
a
Included patients who were Pacific Islanders and patients for whom no race or ethnicity data were recorded in the electronic health record.
b
Calculated as weight in kilograms divided by height in meters squared.