Your Article Summary
See Latest ArticlesManic/Hypomanic Symptom Burden and Cardiovascular Mortality in Bipolar Disorder
Psychosomatic Medicine, 07/01/09
Fiedorowicz JG et al. - Participants with bipolar I disorder may face a greater risk of cardiovascular mortality than those with bipolar II disorder. This difference in cardiovascular mortality risk may reflect manic/hypomanic symptom burden.
Methods- Participants with major affective disorders were recruited for the National Institute of Mental Health Collaborative Depression Study and followed prospectively for up to 25 years.
- A total of 435 participants met the diagnostic criteria for bipolar I (n = 288) or bipolar II (n = 147) disorder based on Research Diagnostic Criteria at intake and measures of psychiatric symptoms during follow-up.
- Diagnostic subtypes were contrasted by cardiovascular mortality risk using Cox proportional hazards regression.
- Affective symptom burden (the proportion of time with clinically significant manic/hypomanic or depressive symptoms) and treatment exposure were additionally included in the models.
- Thirty-three participants died from cardiovascular causes.
- Participants with bipolar I disorder had more than double the cardiovascular mortality risk of those with bipolar II disorder, after controlling for age and gender (hazard ratio = 2.35, 95% Confidence Interval = 1.04–5.33; p = .04).
- The observed difference in cardiovascular mortality between these subtypes was at least partially confounded by the burden of clinically significant manic/hypomanic symptoms which predicted cardiovascular mortality independent of diagnosis, treatment exposure, age, gender, and cardiovascular risk factors at intake.
- Selective serotonin uptake inhibitors seemed protective although they were introduced late in follow-up. Depressive symptom burden was not related to cardiovascular mortality.
Today in Heart Failure...keeping you current
Receive free subspecialty "5-minute updates" via email
Omega-3 fatty acids and heart failure
Current Atherosclerosis Reports, 11/12/09
Effects of high-dose versus low-dose losartan on clinical outcomes in patients with heart failure (HEAAL study): a randomised, double-blind trial
The Lancet - Early Online Publication, 11/18/09
Coenzyme Q10; an adjunctive therapy for congestive heart failure?
New Zealand Medical Journal, 11/04/09