Use of certain antihypertensives correlates with reduced incidence of depression
Continued use of certain angiotensin agents, calcium antagonists and beta-blockers was linked to decreased rates of depression in a Danish cohort, researchers reported.
An analysis of diuretics included for comparison did not find any associations between diuretic use and incident depression or the composite outcome of depression diagnosis or use of antidepressant medications.
“Using Danish nationwide population-based registers, we confirmed our overall hypothesis that continued use of classes of angiotensin agents and calcium antagonists was associated with decreased rates of incident depression, whereas use of diuretics was not,” Lars Vedel Kessing, MD, DMSc, clinical professor in the department of clinical medicine at the University of Copenhagen, Denmark, and colleagues wrote. “Surprisingly, beta-blockers as a group were also associated with decreased rates of depression.”
For this study, published in Hypertension, researchers used population-based registries to evaluate whether any of the 41 most common antihypertensive drugs were associated with an altered risk for diagnosis of depressive disorder at a psychiatric hospital or a combined outcome depression diagnosis or use of antidepressant medications.
This analysis included 3,747,190 patients who were on an antihypertensive drug between 2005 and 2015.
According to this study, of the 41 antihypertensive therapies analyzed, nine were associated with a reduced risk for depression:
two angiotensin agents (enalapril and ramipril);
three calcium antagonists (amlodipine, verapamil and verapamil combinations); and
four beta-blockers (propranolol, atenolol, bisoprolol and carvedilol).
All analyses of these drugs passed Bonferroni correction, with all P values less than .001, except for verapamil (P = .004) and two analyses of verapamil combinations (P = .022; P = .02).
Researchers also observed that individuals who were not on any antihypertensive during the study period, compared with those on one or two prescriptions, experienced lower risk for developing depression. This relationship indicated that patients with hypertension, CVD or cerebrovascular diseases may experience greater risk for developing depression, Kessing and colleagues wrote.
In other findings, patients on three or more antihypertensive medications were at lower risk for receiving a diagnosis of depression vs. individuals on just one or two prescriptions (P < .001).
“As hypertension and cardiovascular and cerebrovascular diseases are associated with increased risk of depression and due to the detrimental effects of depression, it is recommended that clinicians use one of the identified individual nine drugs depending on the somatic indication, especially in patients at increased risk of developing depression, including patients with prior depression or anxiety and patients with a family history of depression,” the researchers wrote.
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