Do patients with bipolar disorders have an increased risk of stroke? A systematic review and meta-analysis

The objective of the current review aimed to assess if patients with bipolar disorder (BD) have an increased risk of stroke. A literature search was conducted on PubMed, Embase, ScienceDirect, and Web of Science for studies published from inception to 20 June 2023 and reporting the association between BD and stroke. Eight studies with 9187894 participants were eligible. Meta-analysis of all eight studies demonstrated that BD patients have an increased risk of stroke as compared to non-BD individuals (HR: 1.60 95% CI: 1.24, 2.05 I =94%). Results did not change in significance on sensitivity analysis. However, results varied on subgroup analysis based on study location, study type, sample size, and follow-up duration. The effect magnitude was unchanged based on the adjustment of diabetes and hypertension and study quality. Patients with bipolar disorder (BD) may have an increased risk of stroke in comparison to the general population. The results are limited by the retrospective nature of the data and high inter-study heterogeneity which demand caution in the interpretation of the outcomes. PROSPERO (CRD42023434365), https://www.crd.york.ac.uk/prospero/.