Intima-Media Thickness in Women With Borderline Personality Disorder

Abstract

Objective: Patients with borderline personality disorder (BPD) may have a higher risk of developing cardiovascular disease caused by altered endocrine, metabolic, and inflammatory parameters. Increased intima-media thickness (IMT) is considered an early marker of atherosclerosis and is associated with most cardiovascular risk factors. Methods: The mean IMT of the common carotid arteries was assessed by B-mode ultrasound in 47 women with BPD and 28 age-matched healthy women. Mean (standard deviation) age for BPD participants was 31.2 (10.4) years and 31.9 (11.0) years for the comparison group. In addition, Adult Treatment Panel III criteria for metabolic syndrome and markers of inflammation were measured. The patients were characterized by applying DSM-IV criteria and obtaining self-reports of adverse childhood experiences. Results: Women with BPD had a significantly higher IMT than healthy women (mean [standard deviation] = 0.41 [0.11] versus 0.34 [0.11] mm, p = .02). In linear regression analysis, IMT was significantly associated with BPD even when adjusting for body mass index (A = 0.27, p = .04) and physical activity (A = 0.29, p = .02). Conclusions: The data suggest that women with BPD are at increased risk of developing subsequent cardiovascular disease.ACEs = adverse childhood experiences; BDI = Beck Depression Inventory; BMI = body mass index; BPD = borderline personality disorder; CG = comparison group; IMT = intima-media thickness; MDD = major depressive disorder; SCID = Structured Clinical Interview for DSM-IV.

Borderline personality disorder traits associate with midlife cardiometabolic risk.

“…Although borderline personality disorder (BPD) is well-studied for its relation to psychosocial impairments, recent research suggests this same pathology may also contribute to physical health risks (Dixon-Gordon, Whalen, Layden, & Chapman, 2015; Quirk et al, 2016; Tomko, Trull, Wood, & Sher, 2014). For instance, diagnostic BPD or BPD-related traits have been found associated with both self-reported cardiovascular disease (El-Gabalawy, Katz, & Sareen, 2010; Lee et al, 2010; Moran et al, 2007; Powers & Oltmanns, 2013) and various heart disease risk factors, such as obesity (Frankenburg & Zanarini, 2006; Greggersen, Rudolf, Brandt, et al, 2011; Greggersen, Rudolf, Fassbinder, et al, 2011; Powers & Oltmanns, 2013; Sansone, Wiederman, & Monteith, 2001), hypertension (El-Gabalawy et al, 2010; Frankenburg & Zanarini, 2006), fasting insulin or diabetes (El-Gabalawy et al, 2010; Greggersen, Rudolf, Brandt, et al, 2011), and preclinical atherosclerosis (carotid artery thickening; Greggersen, Rudolf, Brandt, et al, 2011). In addition to studying risk factors individually, the metabolic syndrome—a composite measure of abnormalities in lipid metabolism, glycemic control, central adiposity, and blood pressure—is commonly used to represent cardiovascular risk and predict incident disease.…”

Unmet challenges in treating hypertension in patients with borderline personality disorder

“…[16] Other screened studies showed an association of BPD with metabolic syndrome and cardiovascular risk factors. [58–61] Furthermore, 6 studies recommended a careful screening of BPD patients for diverse physical health conditions, especially for cardiovascular disorders in general, [34,44,58–60] 3 studies recommended treatment of these somatic comorbidities. [15,34,58] All these described results align with the finding of a suicidality-independent reduction of life-expectance of BPD patients by 9 to 13 years due to somatic comorbidity.…”

Association between personality profile and subclinical atherosclerosis: The role of genes and environment

“…In the last decade, increasing attention has been paid to the influences of psychological factors on the development and progression of cardiovascular diseases. Different pathophysiological pathways, involving endocrine, metabolic and inflammatory altered responses, have been proposed as possible mechanisms through which personality could affect atherosclerosis risk [1]. In particular, studies using the Big Five factor model as the reference framework [2] have repeatedly attested a link of heart rate variability (HRV), the marker of increased autonomic activity and sympathetic activity, which is a major determinant of cardiovascular autonomic control.…”