Review of: Agustini B et al, J Hum Hypertens 2020;34(11):787–794Study Type: Cross-sectional
Patients who took beta blockers were more likely to meet or exceed the clinical cutoff score of 8 on the CESD-10 scale, a sign of clinically significant depressive symptoms, than those who took other antihypertensive drugs. Numerically, 13.4% of patients who used beta blockers showed clinical elevations in depression, whereas between 10.2% and 10.5% of patients who used other antihypertensives showed this elevation. Logistic regression analysis showed that this difference was indeed significant, even when controlling for numerous factors that included gender, age, and smoking history. Other classes of antihypertensives, including angiotensin-receptor blockers, angiotensin-converting enzyme inhibitors, and calcium-channel blockers, were not associated with depression.The researchers also compared the beta blockers based on their selectivity for the β-receptor and their lipophilic properties. Lipophilic medications are more likely to cross the blood-brain barrier, and the more lipophilic beta blockers like propranolol and metoprolol were associated with a higher risk of depression than hydrophilic ones like atenolol. Meanwhile, the more selective beta blockers were less depressogenic, which weakens the argument that blockade at this receptor plays a causative role in depression.
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