The effects of common high blood pressure meds on mood disorders


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Four commonly prescribed blood pressure medications may affect mood disorders such as depression or bipolar disorder, according to new research in the American Heart Association's journal Hypertension.

The study compared four common classes of antihypertensive drugs and risk of mood disorders, and found that two of them were associated with an increased risk for mood disorders, while one seemed to decrease mood disorder risk.

"Mental health is under-recognized in hypertension clinical practice, and the possible effects of antihypertensive drugs on mental health is an area that physicians should be aware of and consider if the treatment of high blood pressure is having a negative impact on their patient's mental health," said Sandosh Padmanabhan, MD, PhD, study author and professor at the Institute of Cardiovascular and Medical Sciences, University of Glasgow in Glasgow, United Kingdom.

Researchers collected data on 525,046 patients (ages 40-80) from two large secondary care Scottish hospitals. They selected 144,066 patients being treated for hypertension with one of the following medications: angiotensin antagonists, beta blockers, calcium channel blockers or thiazide diuretics.

They compared the selected group to 111,936 patients who were not taking any of those drugs. Then, the researchers followed the selected patients for five years while documenting hospitalization for mood disorders. After more than 90 days on the antihypertensive medications, they found that:

  • There were 299 hospital admissions, predominantly due to major depression, among the patients studied, at an average 2.3 years after patients began antihypertensive treatment.
  • Patients on beta-blockers and calcium antagonists were at two-fold increased risk of hospital admission for mood disorder, compared with patients on angiotensin antagonists (angiotensin-converting enzyme inhibitors or angiotensin-receptor blockers).
  • Patients on angiotensin antagonists had the lowest risk for hospitalization with mood disorders compared with patients on other blood pressure meds and patients on no antihypertensive therapy.
  • Patients taking thiazide diuretics showed the same risk for mood disorders compared with patients taking no antihypertensive meds.
  • The presence of co-existing medical conditions increased the risk of mood disorders.

These findings suggest that angiotensin-converting enzyme inhibitors and angiotensin-receptor blockers, which are used to treat hypertension, may be useful as new or "repurposed" treatments for mood disorders, according to Padmanabhan.

"It is important that these results are validated in independent studies. This is a single center study, which looked at the risk of the more severe forms of mood disorders requiring hospitalization. It would be important to study the effect of these drugs on minor to modest changes in mood, as these will have an impact on the quality of life among hypertensive patients," he said.