Hypertension risk and clinical care in patients with bipolar disorder or schizophrenia; a systematic review and meta-analysis

Ayerbe, Luis; Forgnone, Ivo; Addo, Juliet; Siguero, Ana; Gelati, Stefano; Ayis, Salma

doi:10.1016/j.jad.2017.09.002

Cited by 77 publications

(40 citation statements)

References 48 publications

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“…39 Patients with bipolar disorders are also at higher risk for inflammation-associated metabolic syndromes such as myocardial infarction, stroke, atherosclerosis and hypertension. 11,[40][41][42][43] Examination of post-mortem brain tissue can provide valuable insights into a possible association between mood disorders and neuroinflammation. In a meta-analysis of post-mortem studies of brains of patients with MDD measuring cytokines, chemokines and cell-specific markers of microglia and astrocytes, two studies found increased markers of microglia in MDD and four studies found no differences between MDD and healthy controls.…”

Section: Resultsmentioning

confidence: 99%

Inflammation as a treatment target in mood disorders: review

et al. 2020

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Background Mood disorders, i.e. major depressive disorder (MDD) and bipolar disorders, are leading sources of disability worldwide. Currently available treatments do not yield remission in approximately a third of patients with a mood disorder. This is in part because these treatments do not target a specific core pathology underlying these heterogeneous disorders. In recent years, abnormal inflammatory processes have been identified as putative pathophysiological mechanisms and treatment targets in mood disorders, particularly among individuals with treatment-resistant conditions. Aims In this selective review, we aimed to summarise recent advances in the field of immunopsychiatry, including emerging pathophysiological models and findings from treatment ttrials of immunomodulatory agents for both MDD and bipolar disorders. Method We performed a literature review by searching Medline for clinical trials of immunomodulating agents as monotherapy or adjunctive treatments in MDD and bipolar disorders. Included studies are randomised controlled trials (RCTs), cluster RCTs or cross-over trials of immunomodulating agents that had an active comparator or a placebo-arm. Results Current evidence shows an association between inflammation and mood symptoms. However, there is conflicting evidence on whether this link is causal. Conclusions Future studies should focus on identifying specific neurobiological underpinnings for the putative causal association between an activated inflammatory response and mood disorders. Results of these studies are needed before further treatment trials of immunomodulatory agents can be justified.

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Section: Resultsmentioning

confidence: 99%

Inflammation as a treatment target in mood disorders: review

et al. 2020

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“…Primary hypertension is a systemic and complicated disease often accompanied by glycometabolism and lipid metabolism disorders, as well as organic or functional changes in the heart, kidney, brain, and retina, which seriously impairs patient health [5]. The pathogenesis of primary hypertension is complicated.…”

Section: Discussionmentioning

confidence: 99%

Correlation of single-nucleotide polymorphisms of the 1C3435T and ECE-1 genes with the efficacy of irbesartan in primary hypertension

Huangfu¹,

Chang²,

Wang³

et al. 2018

biomedicalresearch

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Objective: To investigate the correlation of single-nucleotide polymorphisms of the Multidrug Resistance Gene (MDR) 1C3435T and the human Endothelin Converting Enzyme (ECE-1) gene with the efficacy of irbesartan in primary hypertension. Methods: A total of 186 patients with primary hypertension in our hospital from May 2015 to December 2016 received irbesartan oral medication. The 1C3435T and ECE-1 gene polymorphic sites were detected. Meanwhile, the plasma concentration was measured every hour after taking medicine for 8 h, and the plasma concentration peak was recorded. The systolic and diastolic blood pressures of the patients were recorded before and after treatment. The relationships between the different genotypes and plasma concentrations, as well as the drop of blood pressure, were compared. The antihypertensive effects of different genotypes were also investigated. Results: The distribution frequencies of the 1C3435T CT, TT, and CC genotypes were 37.63%, 34.95%, and 27.42%, respectively, whereas those of the C-338A CA, AA, and CC genotypes were 32.80%, 30.65%, and 36.56%, respectively. The plasma concentration peak, drop of blood pressure, and total effective rate of the 1C3435T TT genotype were significantly higher than those of CT and CC (P<0.05). The corresponding data of CT were significantly also higher than those of CC (P<0.05). Moreover, the plasma drug concentration, drop of blood pressure, and total effective rate of the C-338A CC genotype were significantly higher than those of CA and AA (P<0.05), and the corresponding data of CA were significantly higher than those of AA (P<0.05). Conclusion: During the oral treatment of primary hypertension by irbesartan tablets, the MDR1 1C3435T TT and ECE-1 C-338A CC genotypes can significantly increase the plasma concentration peak and significantly improve the curative effect.

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“…A recent large representative cohort study in Taiwan showed that schizophrenia patients were 1.93 times more likely to be diagnosed with hypertension in the year before schizophrenia was diagnosed ( 76 ). A possible explanation for the disparity in results is that blood pressure in BD, schizophrenia and MDD patients is poorly recorded and that this may have led previous studies to underestimate the risk of hypertension in SMI patients ( 75 , 77 ).…”

Section: Hypertensionmentioning

confidence: 95%

“…A meta-analysis found that, compared with matched general population controls, people with SMI do not seem to have a significantly increased risk for hypertension (p = 0.07) ( 16 , 52 ). However, another recent meta-analysis in BD and schizophrenia patients did report an increased risk for hypertension in BD patients (Incidence Rate Ratio = 1.27) ( 75 ). A recent large representative cohort study in Taiwan showed that schizophrenia patients were 1.93 times more likely to be diagnosed with hypertension in the year before schizophrenia was diagnosed ( 76 ).…”

Section: Hypertensionmentioning

confidence: 99%

Impact of Psychotropic Medication Effects on Obesity and the Metabolic Syndrome in People With Serious Mental Illness

et al. 2020

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People with serious mental illness (SMI), including schizophrenia, bipolar disorder, and major depressive disorder, have a higher mortality rate and shortened life expectancy. This is mainly attributable to physical diseases, particularly cardiovascular diseases (CVDs). Important risk factors for CVDs are obesity and other metabolic abnormalities, which are especially prevalent in people with SMI. Several factors contribute to this increased risk, including unhealthy lifestyles. Psychotropic medication independently further increases this risk. In this review we want to examine the relationship between obesity and other components of the metabolic syndrome and psychotropic medication in people with SMI.

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Hypertension risk and clinical care in patients with bipolar disorder or schizophrenia; a systematic review and meta-analysis

Cited by 77 publications

References 48 publications

Inflammation as a treatment target in mood disorders: review

Inflammation as a treatment target in mood disorders: review

Correlation of single-nucleotide polymorphisms of the 1C3435T and ECE-1 genes with the efficacy of irbesartan in primary hypertension

Impact of Psychotropic Medication Effects on Obesity and the Metabolic Syndrome in People With Serious Mental Illness

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