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. 2025 Feb;15(2):e70297.
doi: 10.1002/brb3.70297.

Are Adults With Bipolar Disorder at Increased Cardiovascular Risk due to Their Physical, Biochemical, and Physiological Profiles? The FINEXT-BD Study

José Etxaniz-Oses  1   2 , Sara Maldonado-Martín  1   2 , Inaki Zorrilla  3   4   5   6 , Ilargi Gorostegi-Anduaga  1   2 , Maria J Apodaca-Arrizabalaga  7   8 , Ana González-Pinto  3   4   5   6
Affiliations

Are Adults With Bipolar Disorder at Increased Cardiovascular Risk due to Their Physical, Biochemical, and Physiological Profiles? The FINEXT-BD Study

José Etxaniz-Oses et al. Brain Behav. 2025 Feb.

Abstract

Introduction: Bipolar disorder (BD) is associated with considerable morbidity and premature mortality, mainly due to somatic causes. This study aims to determine some physical, exercise capacity-related physiological variables and biochemical markers of health status in adults (45.4 ± 13.1 years) with BD (n = 65) compared to a healthy control (HC) population (n = 29) sample and to estimate cardiovascular risk (CVR) through different methods in the BD group.

Methods: Multiple assessments included body composition, cardiorespiratory fitness (CRF), and biochemical parameters. CVR was calculated using the Framingham Heart Study, SCORE2, and relative risk methods.

Results: The BD population, compared to the HC, showed unfavorable body composition (waist-to-hip ratio, 0.9 ± 0.1 vs. 0.8 ± 0.1; fat body mass, 33.3 ± 10.2 vs. 24.3 ± 8.9%, p ≤ 0.001), CRF (peak oxygen uptake, 25.2 ± 8.2 vs. 33.4 ± 8.7 mL kg-1 min-1; and cardiorespiratory optimal point, 27.9 ± 4.2 vs. 23.6 ± 4.2 ventilation/oxygen uptake ratio, p ≤ 0.05), biochemical concentrations of atherogenic indexes (total cholesterol/high-density lipoprotein cholesterol ratio, 4.1 ± 1.5 vs. 3.3 ± 1.0; and triglycerides/high-density lipoprotein cholesterol ratio, 2.8 ± 2.3 vs. 1.5 ± 1.0, p ≤ 0.05), and inflammatory C-reactive protein (3.8 ± 10.2 vs. 0.9 ± 1.05 mg/dL, p ≤ 0.05). Consequently, CVR showed higher values (p ≤ 0.05) in BD (high risk, 3.1%) compared to HC (low-to-moderate risk, 2.2%) participants, according to SCORE2, higher (p ≤ 0.05) vascular age (49.8 years) than chronological age (45.8 years), with a significant difference (p = 0.005) compared to HC.

Conclusions: This study highlights the importance of specific physical, biochemical, and physiological screening and CVR and vascular age assessment for people with BD. The practical application of these findings would prevent cardiovascular disease in BD and promote a healthier lifestyle as an adjuvant strategy to pharmacological intervention.

Keywords: bipolar disorder; cardiorespiratory fitness; cardiovascular risk factors.

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Conflict of interest statement

The authors declare no conflicts of interest. Dr Gonzalez‐Pinto has received grants and served as a consultant, advisor, or CME speaker for Janssen‐Cilag, Lundbeck, Otsuka, Alter, Angelini, Novartis, Rovi, Takeda, the Spanish Ministry of Science and Innovation (CIBERSAM), the Ministry of Science (Carlos III Institute), the Basque Government, and the European Framework Program of Research.

Figures

FIGURE 1
FIGURE 1
Comparison of cardiovascular risk estimation in the studied groups. FHS: Framingham heart study; RELATIVE, relative risk; SCORE, systematic coronary risk estimation. ***p < 0.001; **p < 0.01; *p <0.05: significant difference between FINEXT‐BD and healthy control (HC).
FIGURE 2
FIGURE 2
Comparison of vascular age (VA) and chronological age (CA) in the studied groups. ***p < 0.001; **p < 0.01; *p < 0.05: significant difference between FINEXT‐BD and healthy (HC).
See this image and copyright information in PMC

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