Document Detail

Depression is associated with decreased blood pressure, but antidepressant use increases the risk for hypertension.
MedLine Citation:
PMID:  19237679     Owner:  NLM     Status:  MEDLINE    
The present study compared blood pressure levels between subjects with clinical anxiety and depressive disorders with healthy controls. Cross-sectional data were obtained in a large cohort study, the Netherlands Study of Depression and Anxiety (N=2981). Participants were classified as controls (N=590) or currently or remittedly depressed or anxious subjects (N=2028), of which 1384 were not and 644 were using antidepressants. Regression analyses calculated the contributions of anxiety and depressive disorders and antidepressant use to diastolic and systolic blood pressures, after controlling for multiple covariates. Heart rate and heart rate variability measures were subsequently added to test whether effects of anxiety/depression or medication were mediated by vagal control over the heart. Higher mean diastolic blood pressure was found among the current anxious subjects (beta=0.932; P=0.03), although anxiety was not significantly related to hypertension risk. Remitted and current depressed subjects had a lower mean systolic blood pressure (beta=-1.74, P=0.04 and beta=-2.35, P=0.004, respectively) and were significantly less likely to have isolated systolic hypertension than controls. Users of tricyclic antidepressants had higher mean systolic and diastolic blood pressures and were more likely to have hypertension stage 1 (odds ratio: 1.90; 95% CI: 0.94 to 3.84; P=0.07) and stage 2 (odds ratio: 3.19; 95% CI: 1.35 to 7.59; P=0.008). Users of noradrenergic and serotonergic working antidepressants were more likely to have hypertension stage 1. This study shows that depressive disorder is associated with low systolic blood pressure and less hypertension, whereas the use of certain antidepressants is associated with both high diastolic and systolic blood pressures and hypertension.
Carmilla M M Licht; Eco J C de Geus; Adrie Seldenrijk; Hein P J van Hout; Frans G Zitman; Richard van Dyck; Brenda W J H Penninx
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-02-23
Journal Detail:
Title:  Hypertension     Volume:  53     ISSN:  1524-4563     ISO Abbreviation:  Hypertension     Publication Date:  2009 Apr 
Date Detail:
Created Date:  2009-03-20     Completed Date:  2009-04-22     Revised Date:  2009-06-18    
Medline Journal Info:
Nlm Unique ID:  7906255     Medline TA:  Hypertension     Country:  United States    
Other Details:
Languages:  eng     Pagination:  631-8     Citation Subset:  IM    
Vrije Universiteit Medical Center, Department of Psychiatry, AJ Ernststraat 887, 1081 HL, Amsterdam, The Netherlands.
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MeSH Terms
Antidepressive Agents / administration & dosage,  adverse effects*
Anxiety Disorders / drug therapy,  epidemiology
Autonomic Nervous System / drug effects
Blood Pressure / drug effects*
Cross-Sectional Studies
Depressive Disorder / drug therapy*,  epidemiology*
Heart Rate / drug effects
Hypertension / epidemiology*
Linear Models
Logistic Models
Middle Aged
Risk Factors
Young Adult
Reg. No./Substance:
0/Antidepressive Agents
Comment In:
Hypertension. 2009 Jul;54(1):e1; author reply e2   [PMID:  19451412 ]

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