In some cases, blood pressure drugs impact mental health – KPCnews.com

You can Lower Your High Blood Pressure with Proven Natural Remedies

Many things have always confused me about the way the medical profession labels things.

Blood Pressure Drugs Impact Mental Health

One of these labels is hypertension. Even though it looks to me like it should be another word for anxiety or depression (because the person is overly tense), it really means high blood pressure.

Blood Pressure Drugs Impact Mental Health

So, antihypertensive drugs are medicines to control high blood pressure, not anxiety or depression.

Blood Pressure Drugs Impact Mental Health

However, some of the antihypertensive drugs do their work directly or indirectly through the nervous system which controls heart rate, blood vessel size and other factors that influence blood pressure. Their effect on the brain and nerves is not always a positive one. But sometimes it can be helpful.

Blood Pressure Drugs Impact Mental Health

The risk of depression is elevated in patients with cardiovascular diseases, including high blood pressure. But several antihypertensive therapies are associated with a reduced risk, and none appear to increase the risk, according to a population-based Danish study that evaluated 10 years of data in nearly four million subjects.

Blood Pressure Drugs Impact Mental Health

Researchers suggest that there is a decreased risk of depression with nine commonly prescribed antihypertensive drugs.

Blood Pressure Drugs Impact Mental Health

In a study spanning from 2005 to 2015, risk of a diagnosis of depression was evaluated in patients taking any of 41 antihypertensive therapies in four major drug categories. These were identified as angiotensin agents (ACE inhibitors or angiotensin II receptor blockers), calcium antagonists, beta-blockers and diuretics.

Blood Pressure Drugs Impact Mental Health

Within these groups, drugs associated with a reduced risk of depression were: two angiotensin agents, enalapril and ramipril; three calcium antagonists, amlodipine, verapamil and verapamil combinations; and four beta-blockers, propranolol, atenolol, bisoprolol and carvedilol. The remaining drugs in these classes and diuretics were not associated with a reduced risk of depression. However, no antihypertensive agent was linked to an increased risk of depression in this study.

All people living in Denmark are assigned a unique personal identification number that permits health information to be tracked across multiple registers, including the Danish Medical Register on Vital Statistics, the Medicinal Product Statistics, and the Danish Psychiatric Central Register.

Data from 3.75 million patients exposed to antihypertensive therapy during the study period were evaluated.

After adjustment for such factors as other diagnoses, gender, age and employment status, incidence of depression among drugs associated with protection identified a risk reduction of 10-25% in most cases in those who had been given 6-10 prescriptions or more than 10 prescriptions.

While the observed protective effect against depression was expected for angiotensin drugs and calcium-channel blockers, that was not the case for beta-blockers.

The system involving angiotensin is one of the pathways known to affect inflammation in the central nervous system and seems to be involved in the regulation of the stress response. Angiotensin agents may also exert anti-inflammatory effects.

Abnormal regulation of calcium inside our nerve cells can happen in depression. So, the possibility of calcium-channel blockers decreasing depression does not seem far-fetched.

In contrast, beta-blockers have been associated with increased risk of depression in some but not all previous studies. Some clinicians (including me) have generally tried to avoid these agents in patients with a history of mood disorders for that reason.

When a big study like this is published, we want to get clear-cut answers about how and when to use the information for the potential benefit of those we treat. However, these results are difficult to interpret on an individual level.

It is difficult to figure out why two of the 16 ACE inhibitors or angiotensin II receptor blockers or four of the 15 beta-blockers or three of the 10 calcium-channel blockers would reduce depression while the others in each class would have no effect.

So, if prior depression or anxiety or a family history of depression becomes a significant issue in the treatment of high blood pressure, this study would suggest that choosing one of these nine drugs might make sense.

However, the literature lists depression as a common side effect of two of the beta-blockers, propranolol and atenolol. So, I might choose one of the other seven instead.

If you suffer with depression and high blood pressure, it will not hurt to discuss this information with your health care provider. But do not change your medicine or dosages on your own.