Monday, August 24, 2020

Several Antihypertensive Medications Associated With Reduced Depression

Adults who take blood pressure medications are not at an increased risk of depression, according to a report published today in Hypertension. In fact, nine of the 41 medications assessed in the study were associated with a decreased incidence of depression.

The medications that were found to protect against depression were amlodipine, atenolol, bisoprolol, carvedilol, enalapril, propranolol, ramipril, verapamil, and verapamil combinations.

Studies have shown that about 30% of people with hypertension or other cardiovascular problems have comorbid depression. Moreover, individuals with both disorders have worse mortality and a poorer quality of life and need more health care services.

“It is, therefore, important to prevent the development of depression in people with hypertension and cardiovascular and cerebrovascular diseases, and widely used treatment interventions should be thoroughly evaluated,” wrote Lars Vedel Kessing, M.D., D.M.Sc., of the University of Copenhagen and colleagues.

Kessing and colleagues used Danish health registry data to assess the incidence of depression and use of antihypertensive medications among all Danish adults who had no history of depression over a 10-year period starting in January 2005. The participants were then divided into groups based on the number of antihypertensive prescriptions they received during the study period. The study encompassed 41 antihypertensive medications in four drug classes: angiotensin agents, calcium antagonists, beta-blockers, and diuretics.

The researchers found that adults who had never been prescribed an antihypertensive had about a 40% to 50% reduced risk of depression compared with adults who had received such prescriptions. However, among adults who did take antihypertensives, the amount of medication usage did not affect depression risk for any of the 41 medications analyzed. For nine of the medications tested, in fact, longer use was associated with reduced depression rates.

The medications associated with reduced depression included two angiotensin agents (enalapril and ramipril), three calcium antagonists (amlodipine, verapamil, and verapamil combination), and four beta-blockers (propranolol, atenolol, bisoprolol, and carvedilol); no diuretics were associated with reduced risk of depression.

“Real-life population-based data suggest a positive effect of continued use of nine individual antihypertensive agents,” wrote the researchers. “This evidence should be used in guiding prescriptions for patients at risk of developing depression including those with prior depression or anxiety and patients with a family history of depression.”



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