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Excessive and premature new-onset cardiovascular disease among adults with bipolar disorder in the US NESARC cohort
- Source :
- The Journal of clinical psychiatry. 76(2)
- Publication Year :
- 2014
-
Abstract
- 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.
- Subjects :
- Adult
Male
medicine.medical_specialty
Bipolar I disorder
Bipolar Disorder
Cross-sectional study
Bipolar II disorder
Life Expectancy
Risk Factors
Internal medicine
mental disorders
medicine
Humans
Bipolar disorder
Psychiatry
Depressive Disorder, Major
business.industry
Incidence (epidemiology)
Incidence
Age Factors
Odds ratio
Middle Aged
medicine.disease
United States
Psychiatry and Mental health
Cross-Sectional Studies
Cardiovascular Diseases
Cohort
Major depressive disorder
Female
business
Subjects
Details
- ISSN :
- 15552101
- Volume :
- 76
- Issue :
- 2
- Database :
- OpenAIRE
- Journal :
- The Journal of clinical psychiatry
- Accession number :
- edsair.doi.dedup.....28947fea02387ddb768fd1f9e7e4fa09