Hypertension linked to severity of bipolar disorders

Similarities may lead to better treatments

Nearly half of patients hospitalized with bipolar disorder may suffer from hypertension, and the younger a person is diagnosed with the psychiatric condition the more likely they are to develop high blood pressure, according to a recent Michigan State University study.

The study, led by MSU psychiatrist Dale D'Mello, analyzed 99 patients hospitalized for bipolar disorder, a condition sometimes called manic-depressive disorder and characterized by mood swings ranging from depression to mental hyperactivity known as mania.

D'Mello presented his findings - which could lead to improved treatments - last week at the American Psychiatric Association's 2010 annual meeting in New Orleans.

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.

"There is a large clinical relevance to the finding hypertension could be linked to the severity of bipolar disorders," he said. "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."

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

"These findings show that we should look to treat hypertension more aggressively in bipolar patients," said D'Mello, who has been studying the link between psychiatric and medical conditions for decades. "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.

D'Mello, a professor in MSU's Department of Psychiatry, part of the colleges of Human Medicine and Osteopathic Medicine, said 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," he said.