Cardiovascular morbidity and mortality in bipolar disorder
Department of Psychiatry, Carver College of Medicine, The University of Iowa, Iowa City, IA, USA
Department of Psychiatry, Carver College of Medicine, The University of Iowa, Iowa City, IA, USAJess G. Fiedorowicz, MD, MS
Department of Psychiatry, Carver College of Medicine, Department of Epidemiology, College of Public Health, The University of Iowa, Iowa City, IA, USA
BACKGROUND: There has been considerable interest in the elevated risk of cardiovascular disease associated with serious mental illness. Although the contemporary literature has paid much attention to major depression and schizophrenia, focus on the risk of cardiovascular mortality for patients with bipolar disorder has been more limited, despite some interest in the historical literature.
METHODS: We reviewed the historical and contemporary literature related to cardiovascular morbidity and mortality in bipolar disorder.
RESULTS: In studies that specifically assess cardiovascular mortality, bipolar disorder has been associated with a near doubling of risk when compared with general population estimates. This may be explained by the elevated burden of cardiovascular risk factors found in this population. These findings predate modern treatments for bipolar disorder, which may further influence cardiovascular risk.
CONCLUSIONS: Given the substantial risk of cardiovascular disease, rigorous assessment of cardiovascular risk is warranted for patients with bipolar disorder. Modifiable risk factors should be treated when identified. Further research is warranted to study mechanisms by which this elevated risk for cardiovascular disease are mediated and to identify systems for effective delivery of integrated medical and psychiatric care for individuals with bipolar disorder.
KEYWORDS: bipolar disorder, cardiovascular disease, mortality, metabolic syndrome, obesity, hypertension
ANNALS OF CLINICAL PSYCHIATRY 2011;23(1):40–47CORRESPONDENCE: Jess G. Fiedorowicz, MD, MS, Department of Psychiatry, Carver College of Medicine, Department of Epidemiology, College of Public Health, The University of Iowa, 200 Hawkins Drive, W278GH, Iowa City, IA 52242, USA E-mail: firstname.lastname@example.orgAnnals of Clinical Psychiatry ©2011 Quadrant HealthCom Inc.