title: Cardiovascular disease and hypertension among adults with bipolar I disorder in the United States.
abstract: OBJECTIVE
  Despite ample evidence of excess cardiovascular mortality in bipolar disorder (BD), few studies have demonstrated increased prevalence of cardiovascular disease (CVD) and/or hypertension (HTN) in BD. We therefore examined this topic in a representative epidemiologic sample.
  
  
  METHODS
  The 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions was used to determine whether prevalence of physician-diagnosed CVD and HTN is elevated among subjects with lifetime bipolar I disorder (BD-I), and whether CVD and HTN are prevalent at earlier ages among subjects with BD-I.
  
  
  RESULTS
  The age-, race-, and sex-adjusted prevalence of CVD was significantly greater among subjects with BD-I versus controls [odds ratio (OR) = 4.95, 95% confidence interval (CI): 4.27-5.75] and versus subjects with major depressive disorder [(MDD); OR =1.80, 95% CI: 1.52-2.14], as was the prevalence of HTN (OR = 2.38, 95% CI: 2.16-2.62 versus controls, OR = 1.44, 95% CI: 1.30-1.61 versus MDD; p < 0.0001 for all). Controlling additionally for marital status, education, income, obesity, smoking, anxiety disorders, and substance use disorders did not substantially alter these findings. The mean age of BD-I subjects with CVD and HTN was 14 and 13 years younger, respectively, than controls with CVD and HTN.
  
  
  CONCLUSIONS
  Adults with BD-I are at increased risk of CVD and HTN, prevalent over a decade earlier than non-BD adults. Strategies are needed to prevent excessive and premature cardiovascular burden in BD-I.
authors.affiliation: Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA. benjamin.goldstein@sunnybrook.ca
authors.forename: Benjamin I
authors.initials: BI
authors.lastname: Goldstein
authors.forename: Andrea
authors.initials: A
authors.lastname: Fagiolini
authors.forename: Patricia
authors.initials: P
authors.lastname: Houck
authors.forename: David J
authors.initials: DJ
authors.lastname: Kupfer
mesh_terms: D000328:Adult; D000367:Age Factors; D001714:Bipolar Disorder / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology*; D002318:Cardiovascular Diseases / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology*; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology
references.citation: Arch Gen Psychiatry. 2004 Aug;61(8):807-16
references.pmid: 15289279
references.citation: Biol Psychiatry. 2006 Oct 15;60(8):889-91
references.pmid: 16730331
references.citation: Psychosomatics. 2007 Sep-Oct;48(5):412-7
references.pmid: 17878500
references.citation: J Chronic Dis. 1986;39(7):495-504
references.pmid: 3722313
references.citation: J Affect Disord. 2006 Oct;95(1-3):13-7
references.pmid: 16777235
references.citation: Ann Clin Psychiatry. 2008 Jul-Sep;20(3):131-7
references.pmid: 18633739
references.citation: Am J Psychiatry. 1999 Sep;156(9):1417-20
references.pmid: 10484954
references.citation: Ann Clin Psychiatry. 2007 Oct-Dec;19(4):313-7
references.pmid: 18058288
references.citation: J Affect Disord. 1987 Nov-Dec;13(3):287-92
references.pmid: 2960722
references.citation: J Clin Psychiatry. 2005 Oct;66(10):1205-15
references.pmid: 16259532
references.citation: Br J Psychiatry. 1980 Mar;136:239-42
references.pmid: 7388226
references.citation: J Psychiatr Res. 2008 Sep;42(11):956-61
references.pmid: 18076906
references.citation: Bipolar Disord. 2007 Aug;9(5):443-52
references.pmid: 17680914
references.citation: Bipolar Disord. 2004 Oct;6(5):368-73
references.pmid: 15383128
references.citation: JAMA. 2000 Jan 26;283(4):506-11
references.pmid: 10659877
references.citation: Psychiatr Serv. 2008 Jul;59(7):760-8
references.pmid: 18586993
references.citation: Drug Alcohol Depend. 2003 Jul 20;71(1):7-16
references.pmid: 12821201
references.citation: Psychosom Med. 2008 Jan;70(1):73-6
references.pmid: 18158377
references.citation: Arch Gen Psychiatry. 2001 Sep;58(9):844-50
references.pmid: 11545667
references.citation: Psychother Psychosom. 2006;75(5):319-26
references.pmid: 16899969
references.citation: JAMA. 2000 Nov 22-29;284(20):2606-10
references.pmid: 11086367
references.citation: Pharmacopsychiatry. 2004 Sep;37(5):211-6
references.pmid: 15470799
references.citation: Bipolar Disord. 2008 Jul;10(5):607-16
references.pmid: 18657245
references.citation: J Clin Psychopharmacol. 2008 Apr;28(2):257-8
references.pmid: 18344750
references.citation: J Clin Psychiatry. 2007 Jun;68(6):917-23
references.pmid: 17592917
references.citation: J Clin Psychiatry. 2007;68 Suppl 4:8-13
references.pmid: 17539694
references.citation: J Affect Disord. 1995 Feb 21;33(2):67-75
references.pmid: 7759663
references.citation: Psychosom Med. 2007 Nov;69(8):729-34
references.pmid: 17942842
references.citation: Neuropsychopharmacology. 2005 Feb;30(2):401-4
references.pmid: 15536492
references.citation: J Clin Psychiatry. 2002 Jun;63(6):528-33
references.pmid: 12088166
references.citation: Eur Arch Psychiatry Clin Neurosci. 2008 Aug;258(5):300-4
references.pmid: 18297417
references.citation: Psychiatr Serv. 2007 Aug;58(8):1073-8
references.pmid: 17664518
references.citation: J Affect Disord. 1987 Mar-Apr;12(2):129-34
references.pmid: 2955003