Bipolar Disorder and Cardiovascular Risk in Rural versus Urban Populations in Colombia: A Comparative Clinical and Epidemiological Evaluation

Juan Pablo Forero; Alexander Ferrera; Jose Daniel Castaño; Sergio Ardila; Tanya Mesa; Dean Hosgood; Eugenio Ferro

doi:10.5334/aogh.3479

Bipolar Disorder and Cardiovascular Risk in Rural versus Urban Populations in Colombia: A Comparative Clinical and Epidemiological Evaluation

Volume 87 (2021): Issue 1

By: Juan Pablo Forero , Alexander Ferrera, Jose Daniel Castaño, Sergio Ardila, Tanya Mesa, Dean Hosgood and Eugenio Ferro

Open Access

|Nov 2021

Abstract

Background: Various multifactorial elements may contribute toward the urban and rural disparities in cardiovascular disease (CVD) risk, particularly among patients with psychiatric diseases.

Objective: To investigate whether rural patients diagnosed and treated for Bipolar Disorder (BD) have different risk profiles and outcomes of CVD compared to urban (BD) patients.

Methods: We conducted a case-control study that included 125 BD patients (cases) from rural Filadelfia, Colombia and 250 BD patients (controls) treated in Bogotá, Colombia. Cases and controls were 2:1, matched by age and sex. We applied the Framingham Heart Study (FHS) risk calculator to assess risk. Differences by rural/urban status (i.e., case-control status) were assessed by chi-square, paired t-tests, and logistic regression.

Findings: Rural BD patients were found to have lower education (p = 1.0 × 10^–4), alcohol consumption (p = 3.0 × 10^–4), smoking (p = 0.015), psychiatric (p = 1.0 × 10^–4) and CV family history (p = 0.0042) compared to urban BD patients. Rural BD patients were 81% more likely to have a more favorable CVD risk profile (OR: 0.19, 95% CI [0.06–0.62]) than urban BD patients, despite rural BD patients having increased CVD morbidity (p = 1.0 × 10^–2).

Conclusion: Based on increase in morbidity but lower predictive risk in the rural population, our study suggests that the FHS-CVD calculator may not be optimal to assess CVD risk in this population.

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DOI: https://doi.org/10.5334/aogh.3479 | Journal eISSN: 2214-9996

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Language: English

Published on: Nov 18, 2021

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© 2021 Juan Pablo Forero, Alexander Ferrera, Jose Daniel Castaño, Sergio Ardila, Tanya Mesa, Dean Hosgood, Eugenio Ferro, published by Ubiquity Press
This work is licensed under the Creative Commons Attribution 4.0 License.

Volume 87 (2021): Issue 1