Cardiovascular risk was evaluated in patients admitted to rural inpatient psychiatric services over a one-year period in a sparsely populated region of the United Kingdom. Care records were analysed for risk factor recording, and cardiovascular risk estimated using the QRISK3 calculator, which estimates 10-year risk of myocardial infarction or stroke. Of eligible patients, risk factor recording as part of routine care was completed in 86% of possible QRISK3 inputs, enabling QIRSK3 estimation in all eligible patients. QRISK3 for this group was significantly raised relative to an age, sex and ethnicity-matched population, and high risk of cardiovascular disease (QRISK3 score >10%) was detected in 28% of patients. The results demonstrate that there is significant unmet need in rural patients for cardiovascular risk reduction that could be identified as part of routine care. An opportunity exists to integrate mental and physical healthcare by routinely assessing cardiovascular risk in rural psychiatric inpatients. Resources and training are needed to produce this risk information and act on it.
Keywords: Integrated care; Ischaemic heart disease; Mental health act detention; Risk reduction; Rurality; Serious mental illness; Stroke.