Bipolar I disorder was associated with a significantly increased 3-year risk of new-onset cardiovascular disease compared to controls (adjusted OR 2.58), with onset occurring nearly 17 years earlier.
Cohort (n=32,101)
Yes
Does bipolar disorder increase the risk of new-onset cardiovascular disease compared to major depressive disorder or controls in adults?
Adults with bipolar disorder have a significantly higher risk of developing premature cardiovascular disease compared to those with major depressive disorder or no mood disorders, independent of traditional cardiovascular risk factors.
Odds Ratio: 2.58 (95% CI 1.84–3.61)
Absolute Event Rate: 6.3% vs 3.7%
p-value: p=<0.0001
BACKGROUND: Cross-sectional studies demonstrate increased prevalence of cardiovascular disease (CVD) among adults with bipolar disorder. However, there is a paucity of prospective data regarding new-onset CVD among adults with bipolar disorder. METHOD: Analyses compared the 3-year incidence of CVD (via participant-reported physician diagnoses) among participants with DSM-IV diagnoses of bipolar I disorder (n = 1,047), bipolar II disorder (n = 392), major depressive disorder (MDD; n = 4,396), or controls (n = 26,266), who completed Wave 1 (2001-2002) and Wave 2 (2004-2005) of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). Analyses also compared the age of participants with new-onset CVD across groups. Multivariable analyses controlled for age, sex, race, cigarette smoking, hypertension, obesity, and alcohol and drug use disorders. RESULTS: The 3-year incidence of CVD among adults with bipolar I disorder, bipolar II disorder, MDD, and among controls was 6.30%, 5.74%, 3.98%, and 3.70%, respectively. The covariate-adjusted incidence of CVD was significantly greater among participants with bipolar I and II disorders versus controls and versus participants with MDD. Adjusted odds ratios (95% CI) were 2.58 (1.84-3.61; P < .0001) for bipolar I disorder vs controls; 2.76 (1.60-4.74; P = .0004) for bipolar II disorder vs controls; 2.11 (1.46-3.04; P = .0001) for bipolar I disorder vs MDD; 2.25 (1.26-4.01; P = .007) for bipolar II disorder vs MDD; and 1.22 (0.99-1.51; P = .06) for MDD vs controls. Bipolar I disorder participants with new-onset CVD were 10.70 ± 2.77 years younger than MDD participants with new-onset CVD and 16.78 ± 2.51 years younger than controls. Bipolar II disorder participants with new-onset CVD were 7.92 ± 3.27 years younger than MDD participants with new-onset CVD and 13.99 ± 2.79 years younger than controls. DISCUSSION: Adults with bipolar disorder are at significantly and meaningfully increased risk to develop CVD over the course of 3 years, even as compared to adults with MDD, and despite controlling for multiple potential confounds. Combined with very early age of CVD onset, this finding underscores the need for early and assertive CVD prevention strategies for people with bipolar disorder.
Goldstein et al. (Wed,) conducted a cohort in Bipolar Disorder (n=32,101). Bipolar I disorder vs. Controls without mood disorders was evaluated on 3-year incidence of new-onset cardiovascular disease (arteriosclerosis, angina, or myocardial infarction) (AOR 2.58, 95% CI 1.84-3.61, p=<0.0001). Bipolar I disorder was associated with a significantly increased 3-year risk of new-onset cardiovascular disease compared to controls (adjusted OR 2.58), with onset occurring nearly 17 years earlier.