Vascular function is not impaired early in the course of bipolar disorder.
OBJECTIVE
Individuals with bipolar disorder face a nearly two-fold increased risk of cardiovascular mortality relative to the general population. Endothelial dysfunction precedes cardiovascular disease and serves as a quantifiable phenotype for vasculopathy. We investigated whether individuals with bipolar disorder had poorer vascular function than controls using a case-control design.


METHODS
The sample of 54 participants included 27 individuals with bipolar disorder and 27 age- and gender-matched controls. Participants underwent an assessment of metabolic (weight, lipids, and insulin resistance) and vascular parameters (endothelial function using flow-mediated dilation; arterial stiffness using pulse wave velocity and estimated aortic pressure).


RESULTS
Participants had a mean age of 32 years and 41% were female. No significant differences were found between groups in endothelial function or arterial stiffness. Individuals with bipolar disorder demonstrated 100% greater insulin resistance.


CONCLUSIONS
The lack of clinically significant differences in vascular function in this young sample suggests any increased risk either occurs later in the course of illness or is largely due to behavioral risk factors, such as smoking, which was balanced between groups. Substantial insulin resistance is identifiable early in course of illness, perhaps secondary to treatment.
Department of Psychiatry, Roy J. and Lucille A. Carver College of Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA 52242, United States.
Dylan P
DP
Murray
Nora S
NS
Metz
William G
WG
Haynes
Jess G
JG
Fiedorowicz
D000328:Adult; D001714:Bipolar Disorder / Q000150:complications / Q000378:metabolism / Q000401:mortality / Q000503:physiopathology; D001808:Blood Vessels / Q000503:physiopathology* / Q000648:ultrastructure; D016022:Case-Control Studies; D004730:Endothelium, Vascular / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D008660:Metabolism; D011603:Psychophysiology; D011673:Pulsatile Flow; D012307:Risk Factors; D014463:Ultrasonography; D014652:Vascular Diseases / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000523:psychology; D059289:Vascular Stiffness