GLASGOW, UK: Antihypertensive medications affect not only blood pressure but also mood disorders, such as depression and bipolar disorder, latest research has found. Calcium antagonists and beta blockers might be associated with an increased risk for mood disorders, while angiotensin-converting enzyme inhibitors and angiotensin-receptor blockers appear to decrease mood disorder risk. Thiazide diuretics do not seem to impact mood disorder risk.

Four commonly prescribed blood pressure medications may impact mood disorders such as depression or bipolar disorder, according to new research. In this first study, that compared four common classes of antihypertensive drugs and risk of mood disorders, two drugs were associated with an increased risk for mood disorders, while one appears to decrease mood disorder risk, according to Dr Sandosh Padmanabhan, study author and Professor at the Institute of Cardiovascular and Medical Sciences, University of Glasgow in Glasgow, United Kingdom.

 

“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 patient’s mental health”

Padmanabhan said.

Hospital admissions due to major depression

Researchers collected data on 525,046 patients (ages 40 to 80) from two large secondary care Scottish hospitals. They selected 144,066 patients being treated for hypertension with either angiotensin antagonists, beta blocker, calcium channel blockers or thiazide diuretics. They were compared to a group of 111,936 patients not taking any of those drugs. Researchers followed the patients for five years documenting hospitalisation for mood disorders, such as depression or bipolar disorder. 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 to patients on angiotensin antagonists (angiotensin-converting enzyme inhibitors or angiotensin-receptor blockers). Patients on angiotensin antagonists had the lowest risk for hospitalisation with mood disorders compared to patients on other blood pressure meds and patients on no antihypertensive therapy. Patients taking thiazide diuretics showed the same risk for mood disorders compared to patients taking no antihypertensive meds. The presence of co-existing medical conditions increased the risk of mood disorders.

More research needed

These findings suggest that angiotensin-converting enzyme inhibitors and angiotensin-receptor blockers that 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 centre study, which looked at the risk of the more severe forms of mood disorders requiring hospitalisation. 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.

The study, titled “Monotherapy With Major Antihypertensive Drug Classes and Risk of Hospital Admissions for Mood Disorders”, was published online ahead of print on October 10 in the Hypertension journal.