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Cardiovascular risk factors in outpatients with bipolar disorder
U M H Klumpers1, K Boom, F M G Janssen
1DeltaBouman Psychiatric Hospital, Rotterdam, The Netherlands.
Insights
Cardiovascular risk factors are elevated in bipolar disorder patients on lithium. While hypertension is common, it is not linked to lithium treatment duration or bipolar disorder length.
Area of Science:
- Psychiatry
- Cardiology
- Pharmacology
Background:
- Bipolar disorder patients exhibit higher cardiovascular disease mortality than the general population.
- The contribution of lithium treatment to this increased cardiovascular morbidity remains unclear.
Purpose of the Study:
- To investigate cardiovascular risk factors in outpatients with bipolar disorder receiving monotherapy lithium.
- To assess the relationship between lithium treatment duration and cardiovascular risk.
Main Methods:
- Evaluated cardiac history, habits, and stress in bipolar outpatients on lithium monotherapy.
- Calculated Quetelet Index (QI), measured blood pressure (BP), and analyzed blood samples.
- Assessed renal function, electrolytes, and glucose concentrations.
Main Results:
- Hypertension was prevalent, with 13 of 81 patients using antihypertensive medication.
- Over half (57.5%) of patients had a QI > 25, indicating overweight or obesity.
- Mean cholesterol levels were 5.7 mmol/L; renal function and glucose levels were normal.
Conclusions:
- A significant proportion of bipolar patients on lithium monotherapy display increased cardiovascular risk factors, notably hypertension.
- No significant correlation was found between the duration of lithium treatment or bipolar disorder and the presence of hypertension.
Background:
The mortality due to cardiovascular diseases in bipolar patients is much higher than in the general population. It is unclear whether lithium treatment contributes to this cardiovascular morbidity.
Methods:
The cardiovascular risk factors in outpatients with bipolar disorder on monotherapy lithium were explored. Cardiac (family) history, important habits and recent stressful events were assessed. Quetelet Index (QI) was calculated and blood samples were taken. Blood pressure (BP) was measured in supine position and during orthostatic challenge.
Results:
40 out of 81 patients on monotherapy lithium were studied in detail. In this group, one patient was hypothyroid; six patients suffered from hypertension. QI was > 25 in 57.5% of the patients; mean cholesterol level was 5.7 mmol/L. Renal functioning, electrolytes and glucose concentrations were normal. There were no significant relationships between the duration of lithium treatment, the duration of bipolar disorder, recent stressful events and hypertension. Out of the group of 81 patients on lithium monotherapy, 13 patients in total used antihypertensive medication, indicating a high prevalence of hypertension in this group as compared to the general population.
Conclusions:
Cardiovascular risk factors, including hypertension, were increased in a large proportion of this population on monotherapy lithium. However, no significant relationships were observed between duration of lithium treatment or bipolar disorder and presence of hypertension.
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