Young people with mood disorders have an increased risk of developing early cardiovascular disease, according to a scientific statement from the American Heart Association.

The statement recommends consideration of major depressive mood disorder and bipolar disorders as independent, moderate risk factors for cardiovascular diseases and is based on a group of recent scientific studies including those that reported cardiovascular events such as heart attacks and deaths among young people.

Published in the journal Circulation, the paper said more doctors should begin actively monitoring that risk and intervening. While the links between depression and adult cardiovascular disease are well known, the statement called on more awareness and action in catching the risks among youth with mood disorders.

Dr. Benjamin Goldstein, the statement’s chief author, said of the findings:

“This is really something people should be looking at. We think of mood disorders as mental illnesses, but they also have physical manifestations. It is well known if you look at adults with mood disorders, they don’t get the same standard of care for heart disease or stroke. We want to make sure that doesn’t happen to teenagers.”

From the American Heart Association’s statement:

In 2011, an expert panel identified four conditions – chronic inflammatory disease, human immunodeficiency virus, Kawasaki disease, and nephrotic syndrome – that predispose young people to a moderate risk of developing atherosclerosis before 30 years old. Atherosclerosis is a buildup of plaque in the arteries that can lead to heart attack and stroke.

Monday’s statement said major depressive mood disorder and bipolar disorder meet all the same criterion for risk as these conditions – but that they are even more widespread in adolescents than all four of the conditions combined. The prevalence of these mood disorders in the United States among adolescents is about 10 percent.

Depressive mood disorder and bipolar disorder are the first and fourth most disabling conditions among adolescents worldwide, according to the statement.

In their analysis of published research, the statement authors found that teens with major depression or bipolar disorder are more likely than other teens to have several cardiovascular disease risk factors, including:

• high blood pressure
• high cholesterol
• obesity, especially around the midsection
• type 2 diabetes
• hardening of the arteries

 

The biological causes of these increased risks remain unclear, but they may be related to inflammation and other types of cell damage, which some studies found occur more frequently among teens with mood disorders.

Dr. Goldstein said a “transformational change” is needed – more awareness and regular screening and intervention – to improve the future for children and youth with mood disorders:

“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.”

While teens with mood disorders were more likely than other teens to participate in unhealthy behaviors, like drug abuse, smoking, and being physically inactive, those factors alone do not explain the increased cardiovascular risk.

In addition, medications do not fully explain the increased risk. While certain mood medications can cause weight gain, and high blood pressure, cholesterol and blood-sugar levels, most of the teens in the studies analyzed were not taking medication.

Based on their findings, the statement authors advise including major depression and bipolar disorder as moderate risk factors for cardiovascular disease in teens.