McGowan Niall M, Nichols Molly, Bilderbeck Amy C, Goodwin Guy M, Saunders Kate E A
Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, OX3 7JX, UK.
Academic Centre, John Radcliffe Hospital, Oxford University Clinical School, Oxford, OX3 9DU, UK.
Int J Bipolar Disord. 2021 Feb 1;9(1):5. doi: 10.1186/s40345-020-00209-x.
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.
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.
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.
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.
双相情感障碍（BD）与心血管疾病的高死亡率和过早死亡相关。血压升高（BP）是心血管风险的主要因素。然而，与其他精神疾病相比，很少有研究对BD患者的血压进行过检查。此外，尽管人们越来越关注将现有的抗高血压药物重新用作可能的新型BD治疗方法，但目前尚不清楚血压与情绪不稳定之间的关联。因此，我们研究了BD与边缘型人格障碍（BPD）之间的血压差异，BPD是一种通过慢性情绪不稳定具有相似症状特征的疾病。
在症状严重程度自动监测（AMoSS）研究中评估的总共106名成年人（38名BD患者、25名BPD患者和43名健康对照者）完成了为期一周的家庭血压监测评估和情绪的生态瞬时评估。我们检查了平均血压和血压变异性的组间差异及其与情绪不稳定的关联。
与BPD患者（35.7±5.3，mmHg，P = 0.03）和对照参与者（37.3±6.3，mmHg，P = 0.036）相比，BD患者的静息脉压显著更宽（40.8±7.4，mmHg）。收缩压与悲伤情绪不稳定呈负相关，平均血压的所有测量值（收缩压、舒张压和平均动脉压）与积极情绪不稳定呈负相关。
本研究表明BD与健康对照者和临床对照者之间的血压差异处于正常血压范围内。早期脉压增宽可能是BD的一种可改变的病理生理特征，会带来后期心血管风险。血压可能是情绪不稳定的一个重要的跨诊断预测指标和潜在的明确治疗靶点。
