Does High Blood Pressure Influence Bipolar Disorder?

Almost half of patients hospitalized with bipolar disorder may also suffer from hypertension, according to a new study. The younger a person is diagnosed with the psychiatric condition, the more likely they are to develop high blood pressure.

The study assessed 99 patients hospitalized for bipolar disorder, a condition sometimes called manic-depressive disorder and characterized by mood swings ranging from depression to mania.  The findings were reported at the American Psychiatric Association 2010 Annual Meeting.

Dale D’Mello, professor of psychiatry at Michigan State University, said:

“There is a large clinical relevance to the finding hypertension could be linked to the severity of bipolar disorders. There is some similarity to the pathology of the two conditions; they both can be triggered by stress and are tied to the excretion of norepinephrine, a hormone affecting how the brain reacts to stress.”

While the connection between such disorders and cardio-metabolic conditions such as heart disease and diabetes has been established, D’Mello also discovered bipolar patients with high blood pressure suffered higher levels of mania.

Understanding how bipolar disorder and cardio-metabolic conditions are linked could help physicians create more effective treatment options.

“These findings show that we should look to treat hypertension more aggressively in bipolar patients,” D’Mello says. “There also is some evidence hypertension may lead to brain lesions; diagnosing high blood pressure and treating it earlier may change the medical outcomes for people battling bipolar disorders.”

In addition, similar to how certain drugs such as lithium do not work as well in bipolar patients who are obese, different medications may be identified that work better.

“The finding of a higher severity score for persons with hypertension is new and surprising,” Dr. D’Mello commented. “We wonder if the hypertension is an epiphenomenon of bipolar disorder, perhaps. And this is in the acute state. We don’t know whether 6 months down the road when patients are stable, whether this association will still be seen.”

D’Mello says the next step is to discover how hypertension and other cardio-metabolic disorders interact over the long term.

“Is this just a point of time comparison or an enduring concern? We need to follow people and look at mania ratings over a period of time and not just during a hospital stay.”

Image: Durant Weston/Flickr