- Recent research suggests that bipolar disorder increases the risk of major adverse cardiac events, such as heart attack and stroke.
- The risk of heart disease appears to be higher in people with bipolar disorder, even when researchers control for traditional cardiovascular risk factors such as smoking and obesity.
- Getting recommended heart health screening tests and practicing healthy lifestyle habits is important for managing the risk of heart disease.
Bipolar disorder (BD) can affect more than your mood and mental health. It may also raise your risk of other health conditions, including heart disease.
Recent research has found that people with BD have an increased risk of major adverse cardiac events, such as heart attack and stroke.
A 2022 study in the journal Psychosomatic Medicine followed 288 adults with BD over an average period of 16.5 years. All of the study participants lived in Olmsted County, Minnesota.
Even when the researchers adjusted their analysis for traditional cardiovascular risk factors, they found that people with BD were more likely than average to have major adverse cardiac events.
“The vast majority of studies that have examined the cardiovascular disease-BD intersection have found that people with BD have increased risk for heart disease and for cardiovascular death,” Benjamin Goldstein, MD, PhD, told Healthline. Goldstein is a professor of psychiatry and pharmacology at the University of Toronto and director of the Centre for Youth Bipolar Disorder at the Centre for Addiction and Mental Health in Toronto, Canada. He was not involved in the study.
“I think where things differ between studies is whether the significance of those findings holds when you control for traditional cardiovascular risk factors, like obesity,” he continued. “In this instance, they had all the data they needed to say that, yes — there’s an increased risk above and beyond what we would expect if people with BD have more traditional risk factors.”
The authors of the study adjusted their analysis for smoking, diabetes, high blood pressure, high cholesterol, and obesity, as well as substance use disorder and major depressive disorder.
The Psychometric Medicine study adds to a growing collection of research linking BD to increased risk of heart disease.
Another recent study published in the
“Young people with BD should start paying attention to their cardiovascular risk at much earlier ages than the general population,” Rebecca Rossom, MD, MS, lead author of the JAHA study, told Healthline. Rossom is a senior investigator at HealthPartners Institute and an associate professor at the University of Minnesota Medical School in Minneapolis.
“This is because cardiovascular disease is the leading cause of death in this group and contributes to people with BD dying 10 to 15 years earlier than the general population,” she said.
Some traditional risk factors for heart disease are more common than average in people with BD. For example, people with BD are more likely than average to smoke and have obesity.
This may help account for some of the increased risk of heart disease in people with BD, but the Psychometric Medicine study suggests that BD itself also raises the risk.
Scientists don’t yet know why BD raises the risk of heart disease, but it might reflect the role that inflammation and oxidative stress play in both conditions.
“There are shared biological processes that appear to be central both to heart disease and BD that are likely not fully captured by traditional cardiovascular risk factors,” said Goldstein. “I think that’s where there’s an opportunity for new treatment approaches.”
More research is needed to understand the link between BD and heart disease and develop treatment approaches to address both conditions.
In the meantime, people with BD can take steps to manage more traditional risk factors for heart disease.
“In most healthcare systems, we wait until age 40 to address cardiovascular risk, but we can’t wait that long for people with BD,” said Rossom. “Adults of any age with BD need to pay attention to and address cardiovascular risk factors, including smoking, obesity, cholesterol, blood pressure, and blood glucose/A1c.”
If you have BD, consider asking your doctor about screening tests for blood cholesterol, blood pressure, and blood sugar levels. Your doctor can help you learn when to get these tests and what the results mean.
Your doctor can also help you develop a plan for managing your risk of heart disease. In some cases, they may recommend lifestyle changes, medication, or other treatments to help prevent or treat heart disease.
Practicing healthy lifestyle habits is important for managing chronic conditions, including BD and heart disease.
The American Heart Association recommends the following lifestyle habits to reduce your risk of heart disease, heart attack, and stroke:
- Commit to quitting smoking, if you smoke.
- Eat a nutrient-rich diet that emphasizes vegetables, fruits, whole grains, and lean proteins, while limiting your intake of saturated fat, trans fat, cholesterol, and added sugars.
- Get daily physical activity, while aiming for at least 150 minutes of moderate-intensity activity per week.
- Maintain a moderate weight by consuming no more calories than you burn.
- Follow your treatment plan for managing diabetes, if you have this condition.
- Limit your consumption of alcohol.
- Take steps to reduce stress.
Weight gain is a common side effect of certain treatments for BD.
Many people with overweight or obesity find it challenging to lose weight and maintain weight loss. But getting physically active can benefit heart health even without weight loss.
“One thing that people with BD can do is increase their aerobic or cardiorespiratory fitness,” said Goldstein. “Getting more aerobically fit has a strong effect on reducing the risk of heart disease, and that’s something that people can do even if they don’t lose weight.”
Quitting smoking may also be challenging, but resources are available to help.
“There are treatments available to help people quit smoking that are safe and effective for people with bipolar disorder,” said Rossom. If you smoke, consider asking your doctor about treatments to help you quit.
Recent research suggests that BD may raise the risk of heart disease, even among young adults.
To manage the risk of heart disease, it’s important to get recommended screening tests and practice healthy lifestyle habits. In some cases, your doctor may also prescribe medication or other treatments to help prevent or treat heart disease.
Future studies may help scientists better understand the link between BD and heart disease. This may lead to the development of new treatment approaches that help address the underlying causes of both conditions.