Unmet challenges in treating hypertension in patients with borderline personality disorder: A systematic review

Area of Science:

• Cardiology
• Psychiatry
• Pharmacology

Background:

• Hypertension management in patients with borderline personality disorder (BPD) presents substantial challenges for caregivers.
• Therapeutic conflicts arise from drug-drug and drug-disease interactions in concurrent psychotropic and antihypertensive treatments.
• Current guidelines lack recommendations for treating hypertensive BPD patients, who face elevated cardiovascular risks.

Purpose of the Study:

• To systematically review the available evidence on the prevalence, cardiovascular risk factors, therapeutic conflicts, and treatment recommendations for patients with co-occurring hypertension and BPD.
• To identify gaps in the literature regarding the management of this high-risk patient population.

Main Methods:

• A systematic literature review was conducted using combined search terms for hypertension and BPD.
• Databases searched included PubMed, MEDLINE, EMBASE, Cochrane, and PsycINFO.
• Eleven articles were included for full-text evaluation.

Main Results:

• A very high prevalence of hypertension and substantial cardiovascular risk were observed in studies of co-occurring BPD and hypertension.
• No studies were identified that specifically addressed harmful drug-drug or drug-disease interactions.
• No studies provided treatment recommendations for concurrent hypertension and BPD.

Conclusions:

• The high prevalence of hypertension in BPD patients and potential therapeutic conflicts necessitate careful evaluation of treatment strategies.
• A significant evidence gap exists regarding specific therapies and strategies to manage therapeutic conflicts in patients with co-occurring hypertension and BPD.
• This patient group is at high risk for cardiovascular disease, highlighting the need for further research and guideline development.