BP meds

Four common blood pressure medications may impact mood disorders such as depression or bipolar disorder, according to a new study.

“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,” said Sandosh Padmanabhan, M.D., Ph.D., study author and professor at the Institute of Cardiovascular and Medical Sciences, University of Glasgow in Glasgow, United Kingdom.

Researchers compared 144,066 patients in two large secondary Scottish hospitals being treated for high blood pressure with angiotensin antagonists, beta-blockers, calcium channel blockers or thiazide diuretics to 111,936 patients not taking any of the drugs. They documented hospitalization for mood disorders for five years.

After more than 90 days on the antihypertensive medications, researchers found:

  • At an average 2.3 years after antihypertensive treatment began, 299 patients were admitted to the hospital, predominantly due to major depression.
  • Patients on beta-blockers and calcium antagonists had a 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 hospitalization 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.

The findings suggest that angiotensin-converting enzyme inhibitors and angiotensin-receptor blockers may be new or “repurposed” treatments for mood disorders, Padmanabhan said.

“It is important that these results are validated in independent studies,” he said. “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.”

The study is published in the American Heart Association journal Hypertension.