The effects of borderline personality disorder (BPD) can extend well beyond the emotional and relationship turmoil frequently caused by the disease. A new study suggests that borderline personality disorder may increase the risk of heart attacks and cardiovascular disease. The study, which was recently published in Personality Disorders: Theory, Research, and Treatment, found that middle-aged adults with borderline personality disorder showed significantly decreased cardiovascular health compared to healthy individuals, a finding with troubling ramifications.

An Unhealthy Connection

The study drew upon health data from about 1,300 participants between the ages of 30 and 50. The data came from a survey that collected a wide range of health and psychological information from participants in Pennsylvania between 2001 and 2005.

The researchers wanted to know if borderline personality disorder carried long-term physical health implications in addition to its potential psychological complications. Specifically, they wanted to know if borderline personality disorder has a long-term effect on heart health.

“Although borderline personality disorder is well studied for its relationship to psychological and social impairments, recent research has suggested it may also contribute to physical health risks,” said Whitney Ringwald MSW, MS, lead author of the study.

To look for a possible connection between borderline personality disorder and heart disease, the researchers used participants’ answers to personality-focused questions to identify traits consistent with borderline personality disorder. The data also included responses from the participants’ friends and family.

Once the researchers identified participants who showed signs of borderline personality traits, they assessed those participants’ heart health data, including blood pressure, body mass index, and cholesterol, glucose, and insulin levels.

The results showed a clear connection between decreased cardiovascular health and borderline personality traits. There was also a correlation between poor heart health and depression, a connection that was already well documented. But when the researchers isolated the borderline traits from the depressive traits, they found that BPD sufferers still had relatively poor heart health, apart from the effects of depression.

“We were surprised by the strength of the effect, and we found it particularly interesting that our measure of borderline personality pathology had a larger effect, and a unique effect, above and beyond depression in predicting heart disease,” said Aidan G.C. Wright, PhD, one of the study’s authors. “There is a large focus on depression in physical health, and these findings suggest there should be an increased focus on personality traits, too.”

A Need for Vigilance

The study’s authors stress that their results should alert mental health professionals and physicians to the hidden dangers of borderline personality disorder. Providers already commonly watch for signs of poor cardiovascular health in depressed patients, but they’re likely unaware of the risks faced by patients with borderline personality traits. With the risks in mind, providers can help their patients understand how to keep themselves healthier later in life.

“Mental health practitioners may want to screen for cardiovascular risk in their patients with borderline personality disorder, ” said Wright. “When discussing the implications of a personality disorder diagnosis with patients, practitioners may want to emphasize the link with negative health outcomes and possibly suggest exercise and lifestyle changes if indicated.”

American Psychological Association, Middle-aged adults with borderline personality disorder potentially at higher risk for heart attacks
Personality Disorders: Theory, Research, and Treatment, Borderline personality disorder traits associated with midlife cardiometabolic risk

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