Thirty-year cardiovascular risk score in patients with newly diagnosed bipolar disorder and their unaffected first-degree relatives

Abstract

Objectives: Bipolar disorder is associated with a decreased life expectancy of 8–12 years. Cardiovascular disease is the leading cause of excess mortality. For the first time, we investigated the Framingham 30-year risk score of cardiovascular disease in patients with newly diagnosed/first-episode bipolar disorder, their unaffected first-degree relatives and healthy individuals. Methods: In a cross-sectional study, we compared the Framingham 30-year risk score of cardiovascular disease in 221 patients with newly diagnosed/first-episode bipolar disorder, 50 of their unaffected first-degree relatives and 119 healthy age- and sex-matched individuals with no personal or first-degree family history of affective disorder. Among patients with bipolar disorder, we further investigated medication- and illness-related variables associated with cardiovascular risk. Results: The 30-year risk of cardiovascular disease was 98.5% higher in patients with bipolar disorder ( p = 0.017) and 85.4% higher in unaffected first-degree relatives ( p = 0.042) compared with healthy individuals in models adjusted for age and sex. When categorizing participants in low cardiovascular risk without considering age and sex distribution among participants, 81% of patients were at low risk, versus 92% of unaffected relatives and 89% of healthy individuals. Of the patients 209 (94.6%) were diagnosed within the preceding 2 years. Smoking was more prevalent among patients with bipolar disorder (45.2%) and their unaffected first-degree relatives (20.4%) compared with healthy individuals (12.8%). Similarly, dyslipidemia was more common among patients with bipolar disorder compared with healthy individuals. Treatment with psychotropic medication with metabolic adverse effects was associated with higher 30-year cardiovascular disease risk score, whereas we did not find illness-related variables associated with cardiovascular risk among patients with bipolar disorder. Conclusion: We found an enhanced cardiovascular disease risk score in patients with newly diagnosed bipolar disorder and their unaffected first-degree relatives, which points to a need for specific primary preventive interventions against smoking and dyslipidemia in these populations.

Cardiovascular risk in patients with severe mental illness in Italy

“…Several studies found lower blood pressure values in patients with schizophrenia and bipolar disorders compared with general population samples [4,31,32]. In the most recent Danish study, the authors argued that the finding was surprising, since subjects in their healthy comparison group were blood donors and likely with a healthy lifestyle [32].…”

“…Several studies found lower blood pressure values in patients with schizophrenia and bipolar disorders compared with general population samples [4,31,32]. In the most recent Danish study, the authors argued that the finding was surprising, since subjects in their healthy comparison group were blood donors and likely with a healthy lifestyle [32]. A tentative explanation may reside in the use of hypotensive medications: either first or second-generation antipsychotics, particularly chlorpromazine, clozapine or quetiapine, are associated with reduced blood pressure and orthostatic hypotension [33].…”

Mental health status of individuals with a mood-disorder during the COVID-19 pandemic in Australia: Initial results from the COLLATE project

“…Further, in mood disorders there is a heightened prevalence of cooccurring medical conditions such as obesity, diabetes and cardiovascular disease (Coello et al, 2019;Dalack and Roose, 1990;Goldstein et al, 2020;Mansur et al, 2019). These have been linked to a more severe coronavirus 2 (SARS-CoV-2) manifestation (Zaman et al, 2020), and may amplify psychological distress by increasing a patient's worries about the heightened personal risk of infection-related mortality or poor long-term health outcomes (Goldstein, 2017;Mansur et al, 2015;Zaman et al, 2020).…”

Blood pressure in bipolar disorder: evidence of elevated pulse pressure and associations between mean pressure and mood instability

“…However, BPD failed to show any differences compared to control participants. Recent evidence suggests a genetic component to CVD in BD, with a higher prevalence of cardiovascular risk factors and increased Framingham risk score present among unaffected siblings/first-degree relatives of individuals with BD (Tsao et al 2019 ; Coello et al 2019 b). Furthermore, several overlapping pleiotropic genes have been implicated with both CVD and BD (Amare et al 2017 ).…”