Cardiovascular risk and bipolar disorder: factors associated with a positive coronary calcium score in patients with bipolar disorder type 1

Abstract

Objective: Cardiovascular disease is the leading cause of death in patients with bipolar disorder. The aim of this study was to evaluate the factors associated with positive coronary calcium score (CCS) in individuals with bipolar disorder type 1. Conclusion: Age and number of psychiatric hospitalizations were significantly associated with higher CCS, which might be a potential method for diagnosis and stratification of cardiovascular disease in bipolar patients. There is a need for increased awareness of risk assessment in this population.

Medical Comorbidities in 181 Patients With Bipolar Disorder vs. Schizophrenia and Related Psychotic Disorders: Findings From a Single-Center, Retrospective Study From an Acute Inpatients Psychiatric Unit

“…This may be explained by the fact that, in addition to the conventional CVD risk factors (i.e., obesity, smoking, raised blood cholesterol), other predisposing factors, such as physical inactivity, unhealthy diet, and low socioeconomic status, are very common among these patients. Evidence from previous studies reported increased rates of "any cardiovascular illness" such as angina, stroke, myocardial infarction, hypertension, in patients with BD (23)(24)(25). For instance, McEvoy et al found out that coronaropathy was 2-3.6-fold higher in patients with SZ (26), while cerebrovascular diseases seemed to be 2.1-3.3-fold higher in patients with BD compared to the general population (27,28).…”

Investigação de fatores de risco cardiovascular modificáveis em pacientes portadores de transtorno afetivo bipolar

“…Alternativamente, pode estar relacionada ao não reconhecimento de outros fatores de risco, como alterações metabólicas (como resistência à insulina e síndrome metabólica), hiperatividade hipotalâmica-pituitária-adrenal, disfunção endotelial e inflamação sistêmica crônica. Além disso, a fisiopatologia do processo de aterosclerose nos portadores de TAB pode diferir da população geral, revelando um mecanismo em comum para ambas as doenças (9,12,13). Um estudo apontou que, mesmo após o controle de potenciais fatores de confusão, como o uso de certas medicações, a gravidade dos sintomas de TAB estava independentemente associada a maior mortalidade por DCV (9).…”

Coronary calcium score as an expression of multisystemic progression of bipolar disorder

“…We read with interest the study by Wageck et al1 recently published in Revista Brasileira de Psiquiatria. In their analysis, the authors describe a positive association between number of hospitalizations and coronary calcium score (CCS), a well-defined predictor of cardiovascular mortality in the general population, in individuals with bipolar disorder (BD).…”

“…From a practical point of view, the findings of Wageck et al1 also highlight the need to reinforce cardiovascular assessment and care in individuals with mood disorders, especially in long-term and severe presentations of these psychiatric conditions. In addition, they shed light on the need for a holistic approach to individuals with mood disorders, blurring the limits between psychiatry and general medicine to provide evidence-based and integrated care.…”