Blood pressure in bipolar disorder: evidence of elevated pulse pressure and associations between mean pressure and mood instability
Abstract Background Bipolar disorder (BD) is associated with excess and premature cardiovascular mortality. Elevated blood pressure (BP) is a leading contributor to cardiovascular risk. However, few studies have examined BP in BD in comparison to other psychiatric disorders. Furthermore, the associa...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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SpringerOpen
2021-02-01
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| Series: | International Journal of Bipolar Disorders |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s40345-020-00209-x |
| _version_ | 1819060648403795968 |
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| author | Niall M. McGowan Molly Nichols Amy C. Bilderbeck Guy M. Goodwin Kate E. A. Saunders |
| author_facet | Niall M. McGowan Molly Nichols Amy C. Bilderbeck Guy M. Goodwin Kate E. A. Saunders |
| author_sort | Niall M. McGowan |
| collection | DOAJ |
| description | Abstract Background Bipolar disorder (BD) is associated with excess and premature cardiovascular mortality. Elevated blood pressure (BP) is a leading contributor to cardiovascular risk. However, few studies have examined BP in BD in comparison to other psychiatric disorders. Furthermore, the association between BP and mood instability is not presently clear despite increasing interest in repurposing existing antihypertensive medications as possible novel BD treatments. Thus we examined BP differences between BD and borderline personality disorder (BPD), a disorder with a similar symptom profile through chronic mood instability. Methods A total of 106 adults (38 BD, 25 BPD, and 43 healthy controls), evaluated in the Automated Monitoring of Symptom Severity (AMoSS) study, completed a week-long home blood pressure monitoring assessment and ecological momentary assessment of mood. We examined group-wise differences in mean BP and BP variability and their association with mood instability. Results BD individuals had a significantly wider resting pulse pressure (40.8 ± 7.4, mmHg) compared to BPD (35.7 ± 5.3, mmHg, P = 0.03) and control participants (37.3 ± 6.3, mmHg, P = 0.036). Systolic BP was negatively associated with sad mood instability, and all measures of mean BP (systolic, diastolic, and mean arterial pressure) were negatively associated with positive mood instability. Conclusions This study demonstrates BP differences between BD and healthy and clinical controls that are within a normotensive range. Early pulse pressure widening may be a modifiable pathophysiological feature of BD that confers later cardiovascular risk. BP may be an important transdiagnostic predictor of mood instability and a potential explicit treatment target. |
| first_indexed | 2024-12-21T14:30:20Z |
| format | Article |
| id | doaj.art-952fa525a5264d5b8c0016eb51fd95b9 |
| institution | Directory Open Access Journal |
| issn | 2194-7511 |
| language | English |
| last_indexed | 2024-12-21T14:30:20Z |
| publishDate | 2021-02-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | International Journal of Bipolar Disorders |
| spelling | doaj.art-952fa525a5264d5b8c0016eb51fd95b92022-12-21T19:00:31ZengSpringerOpenInternational Journal of Bipolar Disorders2194-75112021-02-019111210.1186/s40345-020-00209-xBlood pressure in bipolar disorder: evidence of elevated pulse pressure and associations between mean pressure and mood instabilityNiall M. McGowan0Molly Nichols1Amy C. Bilderbeck2Guy M. Goodwin3Kate E. A. Saunders4Department of Psychiatry, University of Oxford, Warneford HospitalAcademic Centre, John Radcliffe Hospital, Oxford University Clinical SchoolDepartment of Psychiatry, University of Oxford, Warneford HospitalDepartment of Psychiatry, University of Oxford, Warneford HospitalDepartment of Psychiatry, University of Oxford, Warneford HospitalAbstract Background Bipolar disorder (BD) is associated with excess and premature cardiovascular mortality. Elevated blood pressure (BP) is a leading contributor to cardiovascular risk. However, few studies have examined BP in BD in comparison to other psychiatric disorders. Furthermore, the association between BP and mood instability is not presently clear despite increasing interest in repurposing existing antihypertensive medications as possible novel BD treatments. Thus we examined BP differences between BD and borderline personality disorder (BPD), a disorder with a similar symptom profile through chronic mood instability. Methods A total of 106 adults (38 BD, 25 BPD, and 43 healthy controls), evaluated in the Automated Monitoring of Symptom Severity (AMoSS) study, completed a week-long home blood pressure monitoring assessment and ecological momentary assessment of mood. We examined group-wise differences in mean BP and BP variability and their association with mood instability. Results BD individuals had a significantly wider resting pulse pressure (40.8 ± 7.4, mmHg) compared to BPD (35.7 ± 5.3, mmHg, P = 0.03) and control participants (37.3 ± 6.3, mmHg, P = 0.036). Systolic BP was negatively associated with sad mood instability, and all measures of mean BP (systolic, diastolic, and mean arterial pressure) were negatively associated with positive mood instability. Conclusions This study demonstrates BP differences between BD and healthy and clinical controls that are within a normotensive range. Early pulse pressure widening may be a modifiable pathophysiological feature of BD that confers later cardiovascular risk. BP may be an important transdiagnostic predictor of mood instability and a potential explicit treatment target.https://doi.org/10.1186/s40345-020-00209-xBlood pressureMood instabilityBipolar disorderBorderline personality disorderEcological momentary assessment |
| spellingShingle | Niall M. McGowan Molly Nichols Amy C. Bilderbeck Guy M. Goodwin Kate E. A. Saunders Blood pressure in bipolar disorder: evidence of elevated pulse pressure and associations between mean pressure and mood instability International Journal of Bipolar Disorders Blood pressure Mood instability Bipolar disorder Borderline personality disorder Ecological momentary assessment |
| title | Blood pressure in bipolar disorder: evidence of elevated pulse pressure and associations between mean pressure and mood instability |
| title_full | Blood pressure in bipolar disorder: evidence of elevated pulse pressure and associations between mean pressure and mood instability |
| title_fullStr | Blood pressure in bipolar disorder: evidence of elevated pulse pressure and associations between mean pressure and mood instability |
| title_full_unstemmed | Blood pressure in bipolar disorder: evidence of elevated pulse pressure and associations between mean pressure and mood instability |
| title_short | Blood pressure in bipolar disorder: evidence of elevated pulse pressure and associations between mean pressure and mood instability |
| title_sort | blood pressure in bipolar disorder evidence of elevated pulse pressure and associations between mean pressure and mood instability |
| topic | Blood pressure Mood instability Bipolar disorder Borderline personality disorder Ecological momentary assessment |
| url | https://doi.org/10.1186/s40345-020-00209-x |
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