Individuals with bipolar disorder face increased cardiovascular risk, study finds

An analysis of the FINEXT-BD data found that individuals with bipolar disorder have a 3.1% risk of cardiovascular events, compared to a 2.2% risk in their healthy peers. They also tend to have less favorable body composition (e.g., fat body mass, waist-to-hip ratio) and lower cardiorespiratory fitness. The research was published in Brain and Behavior.

Bipolar disorder is a mental health condition characterized by extreme mood swings that include emotional highs (mania or hypomania) and lows (depression). During manic episodes, individuals experience heightened energy, a reduced need for sleep, impulsive behavior, and grandiose thoughts.

Hypomania is a less severe form of mania that does not cause significant impairment but still leads to noticeable changes in mood and behavior. Depressive episodes involve persistent sadness, fatigue, loss of interest in activities, and difficulty concentrating. Without proper treatment, bipolar disorder can significantly impact relationships, work, and overall quality of life.

Study author José Etxaniz-Oses and his colleagues note that analyses of mortality in individuals with bipolar disorder indicate an increased risk of death from cardiovascular diseases. They analyzed data from the FINEXT-BD study, conducted between October 2019 and June 2023 in Vitoria-Gasteiz (Basque Country, Spain).

Their aim was to compare physical and exercise capacity-related physiological parameters and biochemical markers of health status between individuals with bipolar disorder and their healthy peers. Additionally, they sought to estimate the risk of cardiovascular diseases in individuals with bipolar disorder.

The FINEXT-BD study included 65 individuals with bipolar disorder (mean age: 45 years; 37 were women) and 29 healthy participants (mean age: 43 years; 13 were women). The researchers calculated participants’ body mass index (BMI) and conducted various tests assessing physical abilities, physiological measurements, and biochemical markers.

The results showed that, on average, participants with bipolar disorder had higher body mass than healthy participants. They had higher BMI, waist and hip circumferences, and waist-to-hip ratios. They were also more likely to be obese. Additionally, the fat mass of participants with bipolar disorder tended to be higher.

Participants with bipolar disorder also had elevated levels of C-reactive protein (a biomarker of inflammation) and above-optimal levels of several other biomarkers, including glucose. Their cardiorespiratory fitness was lower than that of healthy participants.

Finally, participants with bipolar disorder had a higher estimated cardiovascular risk: 3.1% compared to 2.2% in healthy participants.

“The results of this preliminary analysis of a population with BD [bipolar disorder], presenting CVR factors [cardiovascular risk factors], spotlight the need to promote transdisciplinary healthy lifestyle programs for all people, including those mentally ill, to prevent premature death from somatic causes,” the study authors concluded.

The study highlights the links between bipolar disorder and cardiovascular risk. However, it remains unclear whether these risks are specific to bipolar disorder or associated with mental illness in general. Additionally, the study was conducted with a small group of participants, and results may vary across different populations and countries.

The paper, “Are Adults With Bipolar Disorder at Increased Cardiovascular Risk due to Their Physical, Biochemical, and Physiological Profiles? The FINEXT-BD Study,” was authored by José Etxaniz-Oses, Sara Maldonado-Martín, Inaki Zorrilla, Ilargi Gorostegi-Anduaga, Maria J. Apodaca-Arrizabalaga, and Ana González-Pinto.