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Cardiovascular mortality in bipolar disorder: a population-based cohort study in Sweden

Westman, Jeanette; Hallgren, Jonas; Wahlbeck, Kristian; Erlinge, David LU ; Alfredsson, Lars and Osby, Urban (2013) In BMJ Open 3(4). p.002373-002373
Abstract
Objective To estimate the cardiovascular mortality among persons with bipolar disorder in Sweden compared to the general population. Design Population register-based cohort study with a 20-year follow-up. Setting Sweden. Participants The entire population of Sweden (n=10.6 million) of whom 17101 persons were diagnosed with bipolar disorder between 1987 and 2006. Main outcome measures Mortality rate ratios (MRR), excess mortality (excess deaths), cardiovascular disorder (CVD) and specifically cerebrovascular disease, coronary heart disease, acute myocardial infarction, sudden cardiac deaths and hospital admission rate ratio (ARR). Results Persons with bipolar disorder died of CVD approximately 10years earlier than the general population.... (More)
Objective To estimate the cardiovascular mortality among persons with bipolar disorder in Sweden compared to the general population. Design Population register-based cohort study with a 20-year follow-up. Setting Sweden. Participants The entire population of Sweden (n=10.6 million) of whom 17101 persons were diagnosed with bipolar disorder between 1987 and 2006. Main outcome measures Mortality rate ratios (MRR), excess mortality (excess deaths), cardiovascular disorder (CVD) and specifically cerebrovascular disease, coronary heart disease, acute myocardial infarction, sudden cardiac deaths and hospital admission rate ratio (ARR). Results Persons with bipolar disorder died of CVD approximately 10years earlier than the general population. One third (38%) of all deaths in persons with bipolar disorder were caused by CVD and almost half (44%) by other somatic diseases, whereas suicide and other external causes accounted for less than a fifth of all deaths (18%). Excess mortality of both CVD (n=824) and other somatic diseases (n=988) was higher than that of suicide and other external causes (n=675 deaths). MRRs for cerebrovascular disease, coronary heart disease and acute myocardial infarction were twice as high in persons with bipolar disorder compared to the general population. Despite the increased mortality of CVD, hospital admissions (ARR) for CVD treatment were only slightly increased in persons with bipolar disorder when compared to the general population. Conclusions The increased cardiovascular mortality in persons with bipolar disorder calls for renewed efforts to prevent and treat somatic diseases in this group. Specifically, our findings further imply that it would be critical to ensure that persons with bipolar disorder receive the same quality care for CVD as persons without bipolar disorder. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Epidemiology, Psychiatry, Cardiology
in
BMJ Open
volume
3
issue
4
pages
002373 - 002373
publisher
British Medical Journal Publishing Group
external identifiers
  • wos:000329809200001
  • scopus:84877711140
ISSN
2044-6055
DOI
10.1136/bmjopen-2012-002373
language
English
LU publication?
yes
id
d96c78d2-e17f-457a-a9ee-d0d2b381c448 (old id 4319383)
date added to LUP
2014-03-03 07:57:18
date last changed
2019-10-15 04:28:17
@article{d96c78d2-e17f-457a-a9ee-d0d2b381c448,
  abstract     = {Objective To estimate the cardiovascular mortality among persons with bipolar disorder in Sweden compared to the general population. Design Population register-based cohort study with a 20-year follow-up. Setting Sweden. Participants The entire population of Sweden (n=10.6 million) of whom 17101 persons were diagnosed with bipolar disorder between 1987 and 2006. Main outcome measures Mortality rate ratios (MRR), excess mortality (excess deaths), cardiovascular disorder (CVD) and specifically cerebrovascular disease, coronary heart disease, acute myocardial infarction, sudden cardiac deaths and hospital admission rate ratio (ARR). Results Persons with bipolar disorder died of CVD approximately 10years earlier than the general population. One third (38%) of all deaths in persons with bipolar disorder were caused by CVD and almost half (44%) by other somatic diseases, whereas suicide and other external causes accounted for less than a fifth of all deaths (18%). Excess mortality of both CVD (n=824) and other somatic diseases (n=988) was higher than that of suicide and other external causes (n=675 deaths). MRRs for cerebrovascular disease, coronary heart disease and acute myocardial infarction were twice as high in persons with bipolar disorder compared to the general population. Despite the increased mortality of CVD, hospital admissions (ARR) for CVD treatment were only slightly increased in persons with bipolar disorder when compared to the general population. Conclusions The increased cardiovascular mortality in persons with bipolar disorder calls for renewed efforts to prevent and treat somatic diseases in this group. Specifically, our findings further imply that it would be critical to ensure that persons with bipolar disorder receive the same quality care for CVD as persons without bipolar disorder.},
  author       = {Westman, Jeanette and Hallgren, Jonas and Wahlbeck, Kristian and Erlinge, David and Alfredsson, Lars and Osby, Urban},
  issn         = {2044-6055},
  keyword      = {Epidemiology,Psychiatry,Cardiology},
  language     = {eng},
  number       = {4},
  pages        = {002373--002373},
  publisher    = {British Medical Journal Publishing Group},
  series       = {BMJ Open},
  title        = {Cardiovascular mortality in bipolar disorder: a population-based cohort study in Sweden},
  url          = {http://dx.doi.org/10.1136/bmjopen-2012-002373},
  volume       = {3},
  year         = {2013},
}