Cardiovascular disease and hypertension among adults with bipolar I disorder in the United States.

Full Abstract

OBJECTIVE: Despite ample evidence of excess cardiovascular mortality in bipolar disorder (BD), few studies have demonstrated increased prevalence of cardiovascular disease (CVD) and/or hypertension (HTN) in BD. We therefore examined this topic in a representative epidemiologic sample. METHOD: The 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions was used to determine whether prevalence of physician-diagnosed CVD and HTN is elevated among subjects with lifetime bipolar I disorder (BD-I), and whether CVD and HTN are prevalent at earlier ages among subjects with BD-I. RESULTS: The age-, race-, and sex-adjusted prevalence of CVD was significantly greater among subjects with BD-I versus controls [odds ratio (OR) = 4.95, 95% confidence interval (CI): 4.27-5.75] and versus subjects with major depressive disorder [(MDD); OR =1.80, 95% CI: 1.52-2.14], as was the prevalence of HTN (OR = 2.38, 95% CI: 2.16-2.62 versus controls, OR = 1.44, 95% CI: 1.30-1.61 versus MDD; p < 0.0001 for all). Controlling additionally for marital status, education, income, obesity, smoking, anxiety disorders, and substance use disorders did not substantially alter these findings. The mean age of BD-I subjects with CVD and HTN was 14 and 13 years younger, respectively, than controls with CVD and HTN. CONCLUSIONS: Adults with BD-I are at increased risk of CVD and HTN, prevalent over a decade earlier than non-BD adults. Strategies are needed to prevent excessive and premature cardiovascular burden in BD-I.

Author information

Author/s: Goldstein, Benjamin I (BI); Fagiolini, Andrea (A); Houck, Patricia (P); Kupfer, David J (DJ);

Affiliation: Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA. benjamin.goldstein(-atsign-)sunnybrook.ca

Grants: R25MH060473 (Agency:NIMH NIH HHS)

Journal and publication information

Publication Type: Journal Article; Research Support, N.I.H., Extramural

Journal: Bipolar disorders (Bipolar Disord), published in Denmark. (Language: eng)

Reference: 2009-Sep; vol 11 (issue 6) : pp 657-62

Dates: Created 2009/08/19; Completed 2009/11/05;

PMID: 19689508, status: MEDLINE (last retrieval date: 11/5/2009, IMS Date: )

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