Citation

van Sloten TT, Souverein PC, Stehouwer CDA, Driessen JH. J. Psychopharmacol. 2022; ePub(ePub): ePub.

Copyright

(Copyright © 2022, SAGE Publishing)

DOI

10.1177/02698811221082470

PMID

35388727

Abstract

BACKGROUND: Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs), commonly used antihypertensive drugs, may have a protective effect against depression in older individuals, but evidence in humans is limited. AIMS: We evaluated the risk of depression, among older individuals with hypertension, comparing ACE or ARB initiators to thiazide(-like) diuretic initiators. Thiazide(-like) diuretics were used as control because these drugs are not associated with mood disorders.

METHODS: We used a propensity score-matched new user cohort design with routinely collected data from general practices in England from the Clinical Practice Research Datalink database. We matched 12,938 pairs of new users of ACEIs/ARBs and thiazide(-like) diuretics with hypertension (mean age 67.6 years; 54.7% women). Follow-up time started on the date of drug initiation and ended on the date of treatment discontinuation plus 30 days, or switch to a comparator, occurrence of a study event, death, date of patient's transfer out of practice, or end of the study period. The primary outcome was a composite endpoint of treated depression and nonfatal and fatal self-harm.

RESULTS/OUTCOMES: Compared to the thiazide(-like) diuretic group, ACEIs/ARBs use was not associated with a lower risk of the primary outcome (hazard ratio 0.96 (95% confidence interval: 0.79; 1.15)).

RESULTS did not differ according to lipophilicity, duration of use, and average daily dose, or class (ACEIs or ARBs).

CONCLUSIONS/INTERPRETATION: New use of ACEIs or ARBs is not associated with a lower risk of depression among individuals with hypertension.

Language: en

Keywords

Depression; antihypertensive drugs; hypertension; pharmacoepidemiology