Monotherapy with major antihypertensive drug classes and risk of hospital admissions for mood disorders

Boal, A. H., Smith, D. J. , Mccallum, L., Muir, S., Touyz, R. M. , Dominiczak, A. F. and Padmanabhan, S. (2016) Monotherapy with major antihypertensive drug classes and risk of hospital admissions for mood disorders. Hypertension, 68(5), pp. 1132-1138. (doi:10.1161/HYPERTENSIONAHA.116.08188) (PMID:27733585) (PMCID:PMC5058642)

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Abstract

Major depressive and bipolar disorders predispose to atherosclerosis, and there is accruing data from animal model, epidemiological, and genomic studies that commonly used antihypertensive drugs may have a role in the pathogenesis or course of mood disorders. In this study, we propose to determine whether antihypertensive drugs have an impact on mood disorders through the analysis of patients on monotherapy with different classes of antihypertensive drugs from a large hospital database of 525 046 patients with follow-up for 5 years. There were 144 066 eligible patients fulfilling the inclusion criteria: age 40 to 80 years old at time of antihypertensive prescription and medication exposure >90 days. The burden of comorbidity assessed by Charlson and Elixhauser scores showed an independent linear association with mood disorder diagnosis. The median time to hospital admission with mood disorder was 847 days for the 299 admissions (641 685 person-years of follow-up). Patients on angiotensin-converting enzyme inhibitors or angiotensin receptor blockers had the lowest risk for mood disorder admissions, and compared with this group, those on β-blockers (hazard ratio=2.11; [95% confidence interval, 1.12–3.98]; P=0.02) and calcium antagonists (2.28 [95% confidence interval, 1.13–4.58]; P=0.02) showed higher risk, whereas those on no antihypertensives (1.63 [95% confidence interval, 0.94–2.82]; P=0.08) and thiazide diuretics (1.56 [95% confidence interval, 0.65–3.73]; P=0.32) showed no significant difference. Overall, our exploratory findings suggest possible differential effects of antihypertensive medications on mood that merits further study: calcium antagonists and β-blockers may be associated with increased risk, whereas angiotensin-converting enzyme inhibitors and angiotensin receptor blockers may be associated with a decreased risk of mood disorders.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Padmanabhan, Professor Sandosh and Dominiczak, Professor Anna and Smith, Professor Daniel and Boal, Miss Angela and Mccallum, Dr Linsay and Muir, Dr Scott and Touyz, Professor Rhian
Authors: Boal, A. H., Smith, D. J., Mccallum, L., Muir, S., Touyz, R. M., Dominiczak, A. F., and Padmanabhan, S.
College/School:College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Mental Health and Wellbeing
College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
Journal Name:Hypertension
Publisher:American Heart Association
ISSN:0194-911X
ISSN (Online):1524-4563
Published Online:10 October 2016
Copyright Holders:Copyright © 2016 The Authors
First Published:First published in Hypertension 2016
Publisher Policy:Reproduced under a Creative Commons License

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
676621Ancestry and biological informative markers for stratification of hypertension - The AIM HY studySandosh PadmanabhanMedical Research Council (MRC)MR/M016560/1RI CARDIOVASCULAR & MEDICAL SCIENCES
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689911Clinical study of UMOD NKCC2 interaction on salt-sensitivity in hypertensionSandosh PadmanabhanBritish Heart Foundation (BHF)CS/16/1/31878RI CARDIOVASCULAR & MEDICAL SCIENCES