An Update on the Other Cause of Excess Death in Bipolar Disorder: Cardiovascular Disease

Although much attention has appropriately been paid to suicide risk in bipolar disorder, cardiovascular disease has not received commensurate attention. People with bipolar disorder bear approximately twice the expected risk of cardiovascular disease and mortality. Several potential explanations for this alarming finding are reviewed with a focus on potential targets for clinical intervention. Many medications used to treat bipolar disorder may adversely impact risk factors for cardiovascular disease. People with bipolar disorder are additionally more likely to smoke, less likely to exercise regularly, and less likely to have healthy eating habits. Sleep problems are also nearly ubiquitous in bipolar disorder. Unacceptably, patients with bipolar disorder receive inadequate screening for and management of risk factors for cardiovascular disease, even in countries with universal access to health care. As providers with the most contact with many of these patients, psychiatrists are challenged to come to the fore in addressing this public health disparity. [ Psychiatr Ann. 2019;49(9):380–385.]