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Cardiovascular disease and hypertension among adults with bipolar I disorder in the United States
Open accessAbstract
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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“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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Metadata
- 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
- Venue
- Bipolar Disorders
- Publisher
- Wiley
- Published
- 2009-08-10
- Volume
- 11
- Issue
- 6
- Pages
- 657-662
- ISSN
- 1398-5647 (ISSN-L)
- 1399-5618
- 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
- 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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