Journal article
Vasculopathy related to manic/hypomanic symptom burden and first generation antipsychotics in a sub-sample from the Collaborative Depression Study (CDS)
Psychotherapy and psychosomatics, Vol.81(4), pp.235-243
2012
DOI: 10.1159/000334779
PMCID: PMC3567920
PMID: 22584147
Abstract
Background: Mood disorders substantially increase the risk of cardiovascular disease, though the mechanisms are unclear. We assessed for a dose-dependent relationship between course of illness or treatment with vasculopathy in a well-characterized cohort.
Methods: Participants with mood disorders were recruited for the National Institute of Mental Health Collaborative Depression Study (CDS) and followed prospectively. A cross-sectional metabolic and vascular function evaluation was performed on a sub-sample near completion after a mean follow-up of 27 years.
Results: A total of 35 participants from the University of Iowa (33) and Washington University (2) sites of the CDS consented to a metabolic and vascular function assessment at the Iowa site. In multivariate linear regression, controlling for age, gender, and smoking, manic/hypomanic, but not depressive, symptom burden was associated with lower flow-mediated dilation. Cumulative exposure to antipsychotics and mood stabilizers was associated with elevated augmentation pressure and mean aortic systolic blood pressure. This appeared specifically related to first-generation antipsychotic exposure and mediated by increases in brachial systolic pressure. Although second-generation antipsychotics were associated with dyslipidemia and insulin resistance, they were not associated with vasculopathy.
Conclusions: These results provide evidence that chronicity of mood symptoms contribute to vasculopathy in a dose-dependent fashion. Patients with more manic/hypomanic symptoms had poorer endothelial function. First-generation antipsychotic exposure was associated with arterial stiffness, evidenced by higher augmentation pressure, perhaps secondary to elevated blood pressure. Vascular phenotyping methods may provide a promising means of elucidating the mechanisms linking mood disorders to vascular disease.
Details
- Title: Subtitle
- Vasculopathy related to manic/hypomanic symptom burden and first generation antipsychotics in a sub-sample from the Collaborative Depression Study (CDS)
- Creators
- Jess G Fiedorowicz - Human Cardiovascular Physiology Lab, Institute for Clinical and Translational Science, The University of Iowa, 200 Hawkins Drive, Iowa City, Iowa, 52242William H Coryell - Human Cardiovascular Physiology Lab, Institute for Clinical and Translational Science, The University of Iowa, 200 Hawkins Drive, Iowa City, Iowa, 52242John P Rice - Human Cardiovascular Physiology Lab, Institute for Clinical and Translational Science, The University of Iowa, 200 Hawkins Drive, Iowa City, Iowa, 52242Lois L Warren - Human Cardiovascular Physiology Lab, Institute for Clinical and Translational Science, The University of Iowa, 200 Hawkins Drive, Iowa City, Iowa, 52242William G Haynes - Human Cardiovascular Physiology Lab, Institute for Clinical and Translational Science, The University of Iowa, 200 Hawkins Drive, Iowa City, Iowa, 52242
- Resource Type
- Journal article
- Publication Details
- Psychotherapy and psychosomatics, Vol.81(4), pp.235-243
- DOI
- 10.1159/000334779
- PMID
- 22584147
- PMCID
- PMC3567920
- NLM abbreviation
- Psychother Psychosom
- ISSN
- 0033-3190
- eISSN
- 1423-0348
- Grant note
- P01 HL014388 || HL / National Heart, Lung, and Blood Institute : NHLBI R01 MH025416 || MH / National Institute of Mental Health : NIMH K23 MH083695 || MH / National Institute of Mental Health : NIMH
- Language
- English
- Date published
- 2012
- Academic Unit
- Psychiatry; Epidemiology; Internal Medicine
- Record Identifier
- 9984003907002771
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