I sort of wish the article mentioned more about these patients medical histories and the factors the researchers controlled for. After all, weight gain is a side effect of the majority of medications prescribed for bipolar disorder (a notable exception I can think of is Topamax, which is currently part of an approved (?) combination drug for weight loss, there could be others I’m not aware of). So it’s plausible that the younger the patient was at the time of diagnosis, the longer they’ve been taking drugs to treat the condition, the more they weigh (or the longer they’ve been overweight and/or obese), which is a known risk factor for developing high blood pressure. Even if weight/BMI was controlled for, what about other factors, like other side effects of medications, both mental and physical, that lessen the likelihood of the patients engaging in regular exercise, since cardiovascular fitness, regardless of weight, also figures into hypertension risk? As it is, we are left to wonder more about study design and the validity of conclusions, rather than the questions these conclusions might raise about the connection between bipolar disorder and hypertension.

I was diagnosed with bi-polar and hypertension ten years ago. With weight control and exercise my BP stays under control. Twice in the last 5 yrs I have become overweight and immobile, increasing my BP. After being unable to tolerate BP meds, I was okay with it running 140/100 as long as I felt good. During the last 6 months I developed serious complications affecting all of my organs. My BP finally reached a breaking point of 176/116. Doctors dumped me like crazy because of my manic state. ER’s, when I complained about my problems (focusing on HBP), did nothing trying to discourage my visits. Finally an ER doctor took action. I have a master’s and had been researching. Together we came to conclusions. I had resistance HBP, he gave me an ARB and used his influence to set me up with a new doctor. Early on I had went through every possible drug for my bi-polar and nothing worked. I learned how to live without medication and excelled in my personal and professional life. I have only been taking the ARB’s one week. My BP is running very close to 120/80. My manic state has virtually disappeared. I hope no irreversible damage has been done to my eyes, kidneys, etc…. From my perspective, your accessment that people with bi-polar be agressively treated to control their blood pressure is right on. Every doctor needs to be aware of these findings. Thank you so much for the interest shown in helping people live quality lives.