Teens diagnosed with major depression or bipolar disorder are at a high risk of early heart disease, according to a statement from the American Heart Association (AHA) published Aug. 10 in the journal Circulation. In the statement, healthcare experts urged early screening for heart and blood vessel disease among this population.
“Youth with mood disorders are not yet widely recognized as a group at increased risk for excessive and early heart disease. We hope these guidelines will spur action from patients, families and healthcare providers to reduce the risk of cardiovascular disease among these youth,” lead author Benjamin I. Goldstein, MD, PhD, a child adolescent psychiatrist at Sunnybrook Health Sciences Centre and the University of Toronto, said in a news release.
The AHA reports that major depression and bipolar disorder affect about 10 percent of U.S. teens. Worldwide, major depression is the main cause of disability among teens, and bipolar disorder is the fourth-leading cause. And while there is a lot of evidence suggesting that depression and heart disease are linked in older adults, little is known about how depression early in life may affect the cardiovascular system later on.
For their study, Goldstein and his colleagues looked at existing studies on mood disorders in people under the age of 30. In particular, they focused on those who had been diagnosed with depression or bipolar disorder and for whom there was cardiovascular data, such as blood pressure and cholesterol.
Findings showed that teens with either of the two mood disorders were more likely to have high blood pressure, high cholesterol, excess belly fat, type 2 diabetes and hardening of the arteries. The cause of these increased risk factors for heart disease, however, is unclear.
The researchers were able to rule out several external influences when findings showed that most of the participants were not on antidepressants, but even in those who were, the medications did not explain the association between depression and heart disease. Lifestyle factors such as smoking or inactivity were also unconnected.
As for biological reasons, Goldstein and his colleague speculate the risks may be related to inflammation and other types of cell damage, which studies have found to be more prevalent in teens with mood disorders when compared to other teens. The researchers noted there is ample evidence pointing to a clear link between heart and brain health. For children and teens whose brains are still developing, it is understandable that they are especially susceptible to inflammation and stress, they said.
“Mood disorders are often lifelong conditions, and managing cardiovascular risk early and assertively is tremendously important if we are to be successful in ensuring that the next generation of youth has better cardiovascular outcomes,” Goldstein said. “These disorders indicate an increased risk of heart disease that requires increased vigilance and action at the earliest possible stage.”