Bipolar Disorder Linked to Increased Risk for Cardiac Disease

Bipolar disorder (BD) is a serious mental illness. According to the American Psychiatric Association, “people with bipolar disorder experience intense emotional states that typically occur during distinct periods of days to weeks, called mood episodes. These mood episodes are categorized as manic/hypomanic (abnormally happy or irritable mood) or depressive (sad mood). People with bipolar disorder generally have periods of neutral mood as well. When treated, people with bipolar disorder can lead full and productive lives.”

Unfortunately, people with BD face elevated medical health risks as well. According to a study published in Psychosomatic Medicine, they are more likely to experience a major adverse cardiac event or MACE.

“Researchers analyzed data from the Rochester Epidemiology Project (REP) provided by clinicians in Olmsted County, Minnesota, of individuals older than 30 years who sought primary care between 1998 and 2003,” reported Mary Stroka on Psychiatry Advisor. “They excluded patients with a known history of coronary artery disease, stroke, atrial fibrillation, or heart failure.”

The investigators found that individuals with bipolar disorder were also more likely to present with other risk factors such as “higher body mass index (BMI), hypertension, diabetes, chronic kidney disease, current smoking, alcohol use disorder (AUD), and substance use disorders (SUD). They had lower diastolic blood pressure values and high-density lipoprotein (HDL) cholesterol levels.”

“The hazard ratio for MACE was higher for all risk factors, AUD, bipolar disorder, and major depressive disorder (MDD),” Stroka wrote. “An inverse relationship was reported for MACE and HDL.”

After adjusting for age and sex, the investigators reported an association between bipolar disorder and MACE. That association remained significant after adjusting for smoking, diabetes, hypertension, HDL, BMI, age, and sex, as well as adjusting for AUD, SUD, and MDD.

“Our findings also underscore the importance of the future development of medical and lifestyle interventions to more effectively address the burden of [cardiovascular disease] in patients with [bipolar disorder],” the investigators said. “Such interventions may need to be tailored to the unique challenges presented in [bipolar disorder] and will require interdisciplinary collaborations between psychiatry, psychology, cardiology, physical medicine and rehabilitation, case management, occupational and physical therapy, and likely several other disciplines.”

The study illustrates that effective treatment of bipolar disorder requires a holistic approach. The late founder of Colorado Recovery Richard Warner believed that recovery from mental illness should involve much more than getting rid of symptoms and staying out of the hospital. “It is about regaining a sense of identity, belonging, and meaning in life,” he said.

Dr. Warner’s system at Colorado Recovery includes a residential treatment program, a transitional program, and an intensive outpatient program, and a “clubhouse” community mental health service model. The Warner model is based on a warmer and more human familial setting, comprehensive levels of care that result in a path of self-reliance, and community engagement for connection and a feeling of contribution.

Having a productive role in life is an important part of mitigating the effects of mental illness. This in turn can help reduce secondary health risks such as cardiac events, substance use disorder, and depression.

Our treatment facility provides the services needed to address schizophrenia, bipolar disorder, and other serious mental illnesses which are specific to each individual. Call us at 720-218-4068 to discuss treatment options for you or the person you would like to help.