Elevated Prevalence of Obesity, Metabolic Syndrome, and Cardiovascular Risk Factors in Bipolar Disorder

Abstract

Background Bipolar disorder is associated with excess cardiovascular mortality. We hypothesized outpatients with bipolar disorder would exhibit excess cardiovascular risk factors, particularly among prevalent users of the second generation antipsychotics associated with weight gain and valproic acid derivatives. Methods This chart review of 217 patients with bipolar disorder examined cardiovascular risk factors of the metabolic syndrome. We also evaluated if certain medications were cross-sectionally associated with metabolic syndrome. Results Fifty-six patients were not weighed and many did not have available lipid profiles. Over three-quarters of those with available data (N=161) were overweight or obese (body-mass index ≥ 25) and nearly half were obese (body-mass index ≥ 30). A prevalence exceeding general population estimates was also observed for hypertriglyceridemia, elevated blood pressure/hypertension, and elevated fasting glucose/diabetes. Among those with all requisite data (n = 60), over 50% met criteria for National Cholesterol Education Program defined metabolic syndrome, nearly double the expected prevalence. A trend toward greater prevalence of metabolic syndrome among prevalent users of the second generation antipsychotics associated with weight gain was observed. Conclusions Obesity and the metabolic syndrome were common in patients with bipolar disorder. These patients may be under-evaluated for cardiovascular risk and warrant screening and early intervention.

Greater body mass index is associated with reduced frontal cortical volumes among adolescents with bipolar disorder

“…[1][2][3][4][5][6] Elevated body mass index (BMI) is associated with hypertension, diabetes, certain types of cancer and cardiovascular disease (CVD). [7][8][9] The latter is particularly concerning because CVD is excessively prevalent and occurs prematurely in individuals with BD, 4,10 recently leading the American Heart Association to position BD as an illness that predisposes youth to premature CVD and atherosclerosis.…”

Neurocognitive Functioning in Overweight and Obese Patients with Bipolar Disorder: Data from the Systematic Treatment Optimization Program for Early Mania (STOP-EM)

“…BD is associated with an increased burden of obesity-related conditions, including higher risk for metabolic syndrome, diabetes, hypertension, cardiovascular disease, and dyslipidemia. [17][18][19] Obesity is highly prevalent in this population [20][21][22][23] and has been shown to have a negative impact on the course of the illness. 20,22,24 Moreover, patients with BD who experience significant weight gain during the course of 1 year show impairments in their functioning.…”

Comorbidades médicas em pacientes ambulatoriais com transtorno do humor bipolar tipo I

“…Individuals suffering from BD may be particularly at risk for obesity, a strong predictor of major medical problems including hypertension, cardiovascular disease, and diabetes mellitus, and the prevalence of this condition has been estimated between 8.3%-49% 13,16,17,[19][20][21][22][23] . Obese bipolar patients experience a greater number of lifetime depressive and manic episodes, more severe and difficult-totreat index affective episode 16 , and are more likely to report a lifetime history of suicide attempts 17 .…”