Depression can raise the risk of heart disease and make recovery from cardiovascular disease more difficult.
Past research has also suggested that some blood pressure medications themselves may increase the risk of depression.
However, a new report published today by the American Heart Association (AHA) found that, by and large, that does not seem to be the case.
The new study published in the journal Hypertension concluded that none of the 41 leading blood pressure medications increased the risk of depression.
Moreover, nine of the medications seemed to lower the risk of depression.
Dr. Lars Vedel Kessing, the lead study author and a professor of psychiatry at the Psychiatric Center Copenhagen and the University of Copenhagen in Denmark, wrote in the study that the findings were “highly surprising” in both regards.
A 2016 study concluded that blood pressure medications called calcium antagonists as well as beta-blockers might be associated with increased risk of hospital admission for mood disorders.
Other medications, the study reported, such as angiotensin converting enzyme inhibitors and angiotensin receptor blockers, were associated with a decreased risk of mood disorders.
“Mental health is under-recognized in hypertension clinical practice, and the possible impact 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 patients’ mental health,” Dr. Sandosh Padmanabhan, author of the 2016 study and professor at the Institute of Cardiovascular and Medical Sciences at the University of Glasgow in Scotland, wrote in the research paper.
“Many cardiovascular agents cause higher rates of fatigue and sedation than placebo, and case reports of medication-induced mood syndromes, psychosis, and cognitive disturbances exist for many cardiovascular drugs,” said Dr. Jeff C. Huffman and Dr. Theodore Stern, both researchers from Massachusetts General Hospital in Boston, in a
Overall, wrote Huffman and Stern, “Cardiovascular medications may cause, exacerbate, or relieve neuropsychiatric symptoms.”
The new research suggests that only the latter part of that statement may be true.
The latest study involved data on 3.7 million Dutch people who had taken one or more of the 41 most commonly prescribed high blood pressure medications between 2005 and 2015.
Of these, 37 have been approved for use in the United States by the Food and Drug Administration (FDA).
Researchers looked at four classes of blood pressure medications: angiotensin agents (angiotensin converting enzyme, or ACE, inhibitors and angiotensin II receptor blockers, or ARBs), calcium antagonists, beta-blockers, and diuretics.
Researchers said nine of the drugs significantly lower depression risk: enalapril and ramipril (angiotensin agents), amlodipine, verapamil and verapamil combinations (calcium antagonists), and propranolol, atenolol, bisoprolol, and carvedilol (beta-blockers).
All are FDA-approved medications.
“It is possible that the mechanism involved in decreasing the risk of depression is the anti-inflammatory effect among these nine medications,” Kessing wrote. “In the future, it will be important to compare the inflammatory properties of these nine hypertensives that lowered depression risk.”
“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,” he added. “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.”
Heart disease is the
In addition, the AHA reports that depression can lead to unhealthy lifestyle choices.
Physiologically, depression can also cause elevated levels of stress hormones such as cortisol as well as blood glucose levels, which also can damage the heart and circulatory organs.
Past research has established a link between major depressive and bipolar disorders and increased risk of atherosclerosis, or hardening of the arteries.
Most recently, a study published in August in the Journal of the American Heart Association found that women with peripheral artery disease (PAD) — a narrowing of the arteries in the legs, arms, stomach, and head — and symptoms of depression had worse recoveries than those who did not have depressive symptoms.
“PAD is more than treating the legs and the corresponding pain,” wrote Kim Germaine Emiel Smolderen, PhD, a senior author of the study and a clinical health psychologist and co-director of the vascular medicine outcomes research program in the internal medicine department at Yale University School of Medicine in Connecticut. “We need awareness for the patient as a whole in order to provide patient-centric care.”