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

Goldstein, Benjamin I; Fagiolini, Andrea; Houck, Patricia; Kupfer, David J

doi:10.1111/j.1399-5618.2009.00735.x

Cited by 259Bipolar Disorder and TreatmentSchizophrenia research and treatmentBlood Pressure and Hypertension Studies

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

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Goldstein, Benjamin I, Fagiolini, Andrea, Houck, Patricia, Kupfer, David J·2009·Bipolar Disorders

DOI 10.1111/j.1399-5618.2009.00735.xPMC PMC3401900

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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.

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Cardiovascular disease develops more than a decade earlier in patients with bipolar disorders than in controls.
“CVD develops more than a decade earlier in patients with bipolar disorders than in controls.443”
From 2016 ESC/EAS Guidelines for the Management of Dyslipidaemias (2016) · cites this paper as [443]

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Authors: Goldstein, B. I., Fagiolini, A., Houck, P., & Kupfer, D. J.
Affiliations: Sunnybrook Health Science Centre (CA)
University of Siena (IT)
University of Pittsburgh (US)
Corresponding author: Goldstein, Benjamin I
ORCID: Goldstein, Benjamin I
Fagiolini, Andrea
Kupfer, David J
Venue: Bipolar Disorders
Publisher: Wiley
Published: 2009-08-10
Volume: 11
Issue: 6
Pages: 657-662
ISSN: 1398-5647 (ISSN-L)
1399-5618
DOI: 10.1111/j.1399-5618.2009.00735.x
PMC: PMC3401900
OpenAlex: W1977370435
Cited by: 259
References: 35
Citations by year: 2026: 6 · 2025: 6 · 2024: 8 · 2023: 8 · 2022: 13 · 2021: 13 · 2020: 22 · 2019: 10 · 2018: 19 · 2017: 17 · 2016: 24 · 2015: 30 · 2014: 20 · 2013: 20 · 2012: 17
FWCI: 8.84
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations: Bipolar Disorders (publishedVersion)
PubMed (publishedVersion)
Europe PMC (PubMed Central) (acceptedVersion)
PubMed Central (acceptedVersion)
Use Siena air (University of Siena) (submittedVersion)
Funders: U.S. Department of Veterans Affairs
National Institute of Mental Health (R25MH060473)
Topics: Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
Keywords: bipolar I disorder, cardiovascular disease, hypertension, prevalence, cardiovascular risk, major depressive disorder, comorbidities, NESARC
MeSH terms: Adult, Age Factors, Bipolar Disorder, Cardiovascular Diseases, Female, Humans, Hypertension, Male, Middle Aged, Psychiatric Status Rating Scales, Retrospective Studies, United States, Prevalence, Confidence Intervals, Odds Ratio

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

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