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October 28, 2019
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Borderline personality disorder may increase risk for heart attack

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Aidan Wright

Middle-aged adults with borderline personality disorder, or BPD, may be more likely to have a heart attack, according to results published in Personality Disorders: Theory, Research, and Treatment.

Maladaptive personality traits, as are often seen in BPD pathology, are associated with significant cardiometabolic risk," Aidan Wright, PhD, of the department of psychology at the University of Pittsburgh, told Healio Psychiatry. "The effect is equivalent to over 9 years of aging in midlife. Importantly, this risk persists even when you control for the well-known risk for cardio metabolic problems associated with depression. But, depression doesn’t predict anything when you control for personality."

Previous research has shown a relationship between diagnostic BPD and BPD-related traits and self-reported cardiovascular disease and various cardiometabolic risk factors, according to the researchers. However, the previous research is limited by reliance on self-reported health status, as well as the unresolved potential for confounding of these associations by comorbid depression — a contributor to heart disease.

Ringwald and colleagues examined the association of BPD traits and contemporaneously assessed depressive mood using instrumented measures of cardiometabolic risk in a sample of 1,295 middle-aged individuals. They measured BPD pathology using dimensional, multi-informant trait measures, and participants self-reported depressive symptoms. They indexed cardiometabolic risk using multiple indicators of blood pressure, adiposity, dyslipidemia and insulin resistance.

The researchers found that depressive symptomatology and BPD features were related to the extent of cardiometabolic risk. Upon simultaneous examination, only BPD was associated independently with risk indicators, according to the researchers.

Our findings suggest that individuals with borderline personality features are going to be more complex clinically not just regarding psychiatry, but also physically," Wright said. "Providers should anticipate challenges associated with higher health care involvement and may want to discuss healthy lifestyle choices with their patients.” – by Joe Gramigna

Disclosures: Healio Psychiatry could not confirm relevant financial disclosures at the time of publication.