Study: None of Most Common Blood Pressure Medications Increased Risk of Depression

A recent study found that none of the 41 most common high blood pressure medications increased the risk of depression, whereas 9 medications appeared to lower it, according to a press release from the American Heart Association.

This is the first study to systematically investigate whether individual blood pressure medications might influence the risk of developing depression, according to the authors.

The researchers analyzed real-life data on more than 3.7 million adults who took any of the 41 most-commonly prescribed high blood pressure medications, as reported in health records across several Danish health registries from 2005 to 2015. Further, 37 of these medications are FDA-approved for use in the United States, and patients who had been diagnosed with depression or previously prescribed antidepressants were excluded.

Four main categories of blood pressure-lowering medications were reviewed, including: angiotensin agents (angiotensin converting enzyme inhibitors and angiotensin II receptor blockers); calcium antagonists; beta-blockers; and diuretics, according to the study.

The analysis found that none of the 41 most common high blood pressure medications increased the risk of depression, with 9 of the medications significantly lowering depression risk: 2 of 16 angiotensin agents, 3 of 10 calcium antagonists, and 4 of 15 beta-blockers. In addition, diuretic medications showed no impact on depression risk.

The 9 individual high blood pressure medications found to significantly lower depression risk were enalapril and ramipril (angiotensin agents); amlodipine, verapamil, and verapamil combinations (calcium antagonists); and propranolol, atenolol, bisoprolol, and carvedilol (beta-blockers), according to the study.

“Our study’s findings could help guide prescriptions for patients with high blood pressure who are at risk of developing depression, those with prior depression or anxiety, and patients with a family history of depression,” said study author Lars Vedel Kessing, MD, DMSc, in a press release. “However, if a patient is doing well with their current blood pressure prescription, there is no reason to switch. If depression develops, a medication switch may be considered to one of the nine anti-hypertensive medications that lowered depression risk.”

Limitations of the study included its reliance on a clinical diagnosis of depression, it was not a controlled clinical trial that randomly selected which medication patients receive, and the impact on depression risk was analyzed individually for each blood pressure medication, as they were not tested side-by-side or as combinations of 1 or more other antihypertensive medications.

REFERENCE

None of the most common blood pressure medications increased the risk of depression, some lowered the risk. American Heart Association. https://newsroom.heart.org/news/none-of-the-most-common-blood-pressure-medications-increased-the-risk-of-depression-some-lowered-the-risk. Published August 24, 2020. Accessed August 25, 2020.