None of the 41 most commonly used antihypertensive medications increased the risk of depression, while nine of them appeared to lower it. This emerges from a Danish study that can be read in the journal Hypertension. Depression is common in patients with high blood pressure, heart disease and stroke. This is the first study to systematically examine whether individual antihypertensive medications reduce the risk ofaffect depressioncan.
Prevention with antihypertensive medications
It was very surprising to researchers that none of the 41 most commonly used antihypertensive drugs were associated with an increased risk of developing depression. Some in each of the three classes also showed protective effects against such psychological states. The study authors analyzed real-world data from more than 3.7 million adults. Each of them has taken one of the prescribed medications for high blood pressure. This was reported in the health records of several Danish health registries from 2005 to 2015. Thirty-seven of these drugs are also approved for use in the United States by the U.S. Food and Drug Administration. However, patients diagnosed with depression or previously prescribed antidepressants were excluded. The four main categories that include antihypertensive medications reviewed angiotensin agents (angiotensin-converting enzyme inhibitors, ACE inhibitors, and angiotensin II receptor blockers or ARBs), calcium channel blockers, beta-blockers, and diuretics.
The analysis found that none of the 41 most common high blood pressure medications, such asBeta blockers reduce the risk of depressionincreased. Nine drugs from each category significantly reduced the risk of depression. Of these, 2 of 16 were angiotensin agents, 3 of 10 were calcium antagonists and 4 of 15 were beta blockers. However, diuretics showed no effect on the risk of depression. The nine individual high blood pressure medications found to have a significantly lower risk of depression are enalapril and ramipril (angiotensin drugs). Amlodipine, verapamil and verapamil combinations (calcium antagonists) and propranolol, atenolol, bisoprolol and carvedilol (beta-blockers).
Medical perspectives
It is possible that the mechanism for reducing the risk of depression is the anti-inflammatory effects of these nine drugs. A low-grade inflammatory disease often occurs in cases of high blood pressure and heart disease, as well as depression. So in the future it will be important to compare the inflammatory properties of these nine hypertensives that reduce the risk of depression. The results of this study could therefore serve as a guide for the therapeutic treatment of patients with high blood pressure who are at risk of developing depression. This would also be possible for patients with anxiety and those with a family history of depression. However, if a patient is doing well with their current blood pressure prescription, there is no reason to change.
The resultsthis studyare likely to be generalizable to other populations. However, limitations of the study include that it relied on a clinical diagnosis of depression and was not a controlled clinical trial that randomly selected which medications patients received, as well as the effects on depression risk for each medication against high blood pressure were analyzed individually. They have not been tested simultaneously or as a combination of one or more other antihypertensive medications.
