Psychiatry · Cardiology · 3 h ago
Meta-analysis finds higher cardiovascular incidence in adults with bipolar disorder
A systematic review and meta-analysis of 32 observational studies estimated cardiovascular disease prevalence and incidence in adults with bipolar disorder. Controlled studies found a 66% higher incidence than in comparison groups, although substantial heterogeneity limits the precision and generalizability of the estimates.
- Pooled cardiovascular disease prevalence was 7.70%.
- Incidence was higher in bipolar disorder (IRR 1.66).
- Prevalence estimates showed extreme heterogeneity.
- Moderator data were insufficient to assess contributing factors.
Researchers searched five databases and screened 11,909 records, including 32 observational studies of adults with bipolar disorder. The review, registered in PROSPERO (CRD42023484712), pooled prevalence estimates and incidence rate ratios using random-effects models where data were comparable.
Pooled cardiovascular disease prevalence was 7.70% (95% CI, 5.07–11.52). Estimates were 6.89% for coronary artery disease, 4.45% for cerebrovascular disease and 3.30% for peripheral arterial disease. In controlled incidence studies, bipolar disorder was associated with higher cardiovascular disease incidence (incidence rate ratio, 1.66; 95% CI, 1.32–2.08), with elevated estimates also reported for coronary and cerebrovascular disease.
The authors describe the prevalence figures as broad indicators rather than precise estimates for a single population: estimates were extremely heterogeneous, and incidence data were limited. Observational designs preclude causal conclusions. The studies did not report medication use, lifestyle factors and cardiometabolic comorbidities consistently enough to assess their contribution. The authors say the findings support integrated cardiovascular screening in bipolar disorder populations, but the review does not establish a specific screening approach.
In practice
Adults with bipolar disorder had higher cardiovascular disease incidence in the controlled observational studies included in this meta-analysis (IRR 1.66, 95% CI 1.32–2.08). The authors argue that the findings support integrated cardiovascular screening in this population. However, the review does not specify a screening protocol or establish that bipolar disorder causes the increased risk. Prevalence estimates were extremely heterogeneous, incidence evidence was limited, and available reporting did not permit assessment of medication, lifestyle or cardiometabolic contributors; the results do not define an individual patient’s risk.
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Acta Psychiatrica Scandinavica: Bipolar Disorder and the Risk of Cardiovascular Diseases: A Systematic Review and Meta‐Analysis of Observational Studies ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.