Damegunta Swetha Reddy, Gundugurti Prasad Rao
Asha Bipolar Clinic, Asha Hospital, Hyderabad, Telangana, India.
Indian J Psychol Med. 2017 Sep-Oct;39(5):634-640. doi: 10.4103/IJPSYM.IJPSYM_369_17.
There is increasing recognition of cardiovascular mortality and comorbidity in bipolar disorder (BD) in the recent times. Framingham 10 years risk of coronary heart disease (CHD) has been a widely accepted as a reliable estimate of cardiovascular risk in the general population. A few studies have estimated the relative risk of developing CHD in BDs, in India. We attempt to present a cross-sectional data from a prospective study to estimate the 10 years cardiovascular risk in BD population.
A total of 50 patients with BD aged between 20 and 60 years fulfilling the inclusion and exclusion criteria were enrolled into this study. Demographic variables and clinical evaluations including smoking history, medical and pharmacologic treatment history, physical examination, anthropometric measurements, and clinical laboratories for metabolic profiles were assessed. Using the Framingham 10-year risk questionnaire, the risk for each patient was calculated and compared with that of normal healthy control group.
The risk of developing a future cardiovascular event was 3.26% in BD and 2.02% in controls. We identified that a higher age at onset of illness, waist-hip ratio, total cholesterol, and unemployment showed a strong positive correlation with future CHD risk whereas administration of valproate, lithium for management of BD, higher socioeconomic status and educational status, and nonsmokers was associated negatively with the future CHD risk.
It appears that there is a significant association between BD and metabolic factors, CHD, sociodemographic variables, and underscores the predictive ability of Framingham risk score in detecting cardiovascular diseases.
近年来,双相情感障碍(BD)患者的心血管死亡率和合并症越来越受到关注。弗雷明汉10年冠心病(CHD)风险已被广泛接受为一般人群心血管风险的可靠估计。印度有一些研究估计了双相情感障碍患者患冠心病的相对风险。我们试图展示一项前瞻性研究的横断面数据,以估计双相情感障碍患者10年的心血管风险。
本研究共纳入50例年龄在20至60岁之间、符合纳入和排除标准的双相情感障碍患者。评估人口统计学变量和临床评估,包括吸烟史、药物治疗史、体格检查、人体测量以及代谢指标的临床实验室检查。使用弗雷明汉10年风险问卷,计算每位患者的风险,并与正常健康对照组进行比较。
双相情感障碍患者未来发生心血管事件的风险为3.26%,对照组为2.02%。我们发现,发病年龄较大、腰臀比、总胆固醇和失业与未来冠心病风险呈强正相关,而使用丙戊酸盐、锂盐治疗双相情感障碍、较高的社会经济地位和教育程度以及不吸烟者与未来冠心病风险呈负相关。
双相情感障碍与代谢因素、冠心病、社会人口统计学变量之间似乎存在显著关联,并强调了弗雷明汉风险评分在检测心血管疾病方面的预测能力。