TY - JOUR
T1 - Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers and risk of depression among older people with hypertension
AU - van Sloten, Thomas T
AU - Souverein, Patrick C
AU - Stehouwer, Coen DA
AU - Driessen, Johanna Hm
N1 - Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: T.v.S. was supported by a VENI research grant (916.19.074) from the Netherlands Organization for Scientific Research and a Dutch Heart Foundation research grant (2018T025).
Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: T.v.S. was supported by a VENI research grant (916.19.074) from the Netherlands Organization for Scientific Research and a Dutch Heart Foundation research grant (2018T025).
Publisher Copyright:
© The Author(s) 2022.
PY - 2022/5
Y1 - 2022/5
N2 - 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.
AB - 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.
KW - ASSOCIATIONS
KW - BLOCKADE
KW - BRAIN MICROVESSELS
KW - DOUBLE-BLIND
KW - Depression
KW - IMPROVES
KW - INFLAMMATION
KW - MOOD
KW - NITRIC-OXIDE SYNTHASE
KW - SMALL VESSEL DISEASE
KW - SYMPTOMS
KW - antihypertensive drugs
KW - hypertension
KW - pharmacoepidemiology
U2 - 10.1177/02698811221082470
DO - 10.1177/02698811221082470
M3 - Article
C2 - 35388727
SN - 0269-8811
VL - 36
SP - 594
EP - 603
JO - Journal of Psychopharmacology
JF - Journal of Psychopharmacology
IS - 5
M1 - 02698811221082470
ER -