title: Mood disorder symptoms and elevated cardiovascular disease risk in patients with bipolar disorder.
abstract: OBJECTIVE
  We examined the association between mood symptoms and 10-year CVD risk estimated by Framingham risk score in a cohort of patients with bipolar disorder.
  
  
  METHODS
  Veterans with bipolar disorder and CVD risk factors (N=118) were recruited from outpatient VA clinics. CVD risk factor data were collected from electronic medical records and patient surveys, and used to calculate patient Framingham Scores. The relationship between mood symptoms (depressive, manic) and Framingham scores was examined, as was the relationship between mental health symptoms and individual CVD risk factors (lipids, blood pressure, weight, smoking, and fasting glucose).
  
  
  RESULTS
  Mean sample age was 53 years (SD=9.9), 17% were female, and 5% were African-American. Almost 70% were obese (BMI≥30), 84% had hyperlipidemia, 70% were hypertensive, and 25% had diabetes. Nineteen percent had a Framingham score of >20%, indicative of elevated 10-year risk of developing CVD. After adjusting for age, gender, diabetes diagnosis, smoking status, and mood symptoms, patients with clinically significant depressive symptoms had a 6-fold increased odds of having a Framingham score of >20% (OR=6.1, p=0.03) while clinically significant manic symptoms were not associated with the Framingham score (OR=0.6, p=0.36). Depressive symptoms were also associated with elevated BMI, fasting glucose, and blood pressure.
  
  
  CONCLUSIONS
  Single-site study reliant on cross-sectional and self-reported mood measures.
  
  
  CONCLUSIONS
  After controlling for physiologic correlates, depressive symptoms were associated with greater relative 10-year risk for CVD mortality among patients with bipolar disorder. Interventions that address self-management of depressive symptoms may help persons with bipolar disorder decrease CVD risk.
authors.affiliation: VA Center for Clinical Management Research, Ann Arbor VA Healthcare System, Ann Arbor, MI 48105, USA.
authors.forename: Juliette M
authors.initials: JM
authors.lastname: Slomka
authors.forename: John D
authors.initials: JD
authors.lastname: Piette
authors.forename: Edward P
authors.initials: EP
authors.lastname: Post
authors.forename: Sarah L
authors.initials: SL
authors.lastname: Krein
authors.forename: Zongshan
authors.initials: Z
authors.lastname: Lai
authors.forename: David E
authors.initials: DE
authors.lastname: Goodrich
authors.forename: Amy M
authors.initials: AM
authors.lastname: Kilbourne
mesh_terms: D000328:Adult; D001714:Bipolar Disorder / Q000150:complications / Q000175:diagnosis* / Q000523:psychology*; D002318:Cardiovascular Diseases / Q000523:psychology*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D014728:Veterans / Q000523:psychology