Blood pressure medications do not increase risk for depression, a new study has found. Photo courtesy of Max Pixel/Pixabay
Aug. 24 (UPI) -- None of the most commonly used high blood pressure medications increases the risk for depression, according to a study published Monday by the journal Hypertension.
Use of three classes of anti-hypertensive or blood-pressure control drugs -- angiotensin agents, calcium antagonists and beta-blockers -- was associated with up to 15% decreased risk for depression, the analysis showed.
Among analyzed medications, however, diuretics did not decrease risk for depression, the researchers said.
"It was highly surprising that none of the 41 most-used anti-hypertensives was associated with increased risk of developing depression and that some within each of the three classes of anti-hypertensives showed protective effects against depression," study co-author Dr. Lars Vedel Kessing said in a statement.
"It is possible that the mechanism involved in decreasing the risk of depression is the anti-inflammatory effect among these nine medications," said Kessing, a professor of psychiatry at the Psychiatric Center Copenhagen and the University of Copenhagen
Depression is common among patients with high blood pressure, heart disease and stoke, according to the researchers. Inflammation also is common in patients with both high blood pressure and depression.
While concerns have been raised about medications for these conditions increasing depression risk, the researchers said this is the first systematic analysis of the risk.
For their research, Kessing and his colleagues analyzed real-life data on more than 3.7 million adults in Denmark who took any of the 41 most-commonly prescribed high blood pressure medications between 2005 and 2015.
Thirty-seven of these medications have been approved by the U.S. Food and Drug Administration.
Study participants who had been diagnosed with depression or previously prescribed antidepressants were excluded from the research.
Of the 41 most commonly prescribed high blood pressure medications -- including angiotensin converting enzyme inhibitors, or ACE inhibitors; angiotensin II receptor blockers, or ARBs; calcium antagonists; beta-blockers; and diuretics -- none increased users' risk of depression, the data showed.
In fact, nine medications -- all of which are approved in the United States -- actually might reduce the risk for depression risk, with diuretics not affecting risk one way or another, researchers said.
Based on hazard ratios, the analysis showed that people treated with the medications had a 15% reduced risk for depression or the need for antidepressant drugs. Hazard ratios measure whether patients receiving a treatment progress faster or slower than those not receiving it.
Depending on dose and number of prescriptions being taken, people on the ACE inhibitors enalapril and ramipril, for example, were up to 20% less likely to be diagnosed with depression. Those treated with the beta-blockers propranolol, atenolol, bisoprolol and carvedilol also had a 40% reduced risk for depression, the data showed.
Increased risk for depression shouldn't be the only criteria when selecting a blood pressure-control medication, particularly if the drug is working, Kessing and his colleagues said.
If patients develop depression while on high blood pressure treatment, however, a switch to a drug with a lower risk should be considered, they said.
"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," Kessing said.
"However, if a patient is doing well with their current blood pressure prescription, there is no reason to switch," Kessing said.