Four commonly-prescribed blood pressure drugs may increase the risk of patients developing mood disorders, such as depression or bipolar disorder, according to UK researchers.
Their study, the first of its type to compare anti-hypertensives and risk of mood disorders, found two classes were associated with an increased risk of such disorders, while one appeared to decrease it.
“Mental health is under-recognised in hypertension clinical practice”
The authors noted that previous data from animal models and epidemiological, and genomic studies suggested anti-hypertensives “may have a role in the pathogenesis or course of mood disorders”.
To investigate further, the researchers collected data on 525,046 patients, aged 40-80, 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.
Researchers followed the patients for five years documenting any hospital admissions for mood disorders, and compared them with people in a control group who were not on anti-hypertensives.
There were 299 admissions – mostly due to major depression – among the study participants, at an average 2.3 years after patients began treatment.
Patients on beta-blockers and calcium antagonists had a two-fold higher risk of admission for mood disorder than those on angiotensin-converting enzyme inhibitors or angiotensin-receptor blockers.
Patients on either angiotensin antagonist had the lowest risk for admission with mood disorders, compared to patients on other blood pressure drugs or none at all.
As a result, angiotensin-converting enzyme inhibitors and angiotensin-receptor blockers may be useful as new or “repurposed” treatments for mood disorders, the study authors suggested.
Meanwhile, patients taking thiazide diuretics showed the same risk for mood disorders compared to patients taking no antihypertensive meds.
However, the presence of co-existing medical conditions also increased the risk of mood disorders, according to the new research published in the journal Hypertension.
Common hypertension drugs ‘affect mood disorders’
Study author Professor Sandosh Padmanabhan, from the University of Glasgow, said: “Mental health is under-recognised in hypertension clinical practice.
“The possible impact of anti-hypertensive 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,” he noted.
He added: “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.