High blood pressure is a common problem among people with depression, and the mood disorder is often assumed to be the cause. But a study suggests that certain antidepressants also may be contributing.

Researchers observed data from nearly 3,000 adults. A control group did not have depression or anxiety or take antidepressants. The other 2,028 had current or past depression or anxiety. People with anxiety had slightly higher diastolic blood pressure. But surprisingly, people with current or past depression who were not taking antidepressants had significantly lower systolic blood pressure than the control group.

In people who took tricyclic antidepressants, the risk of mild hypertension was almost doubled, and the risk of serious hypertension was tripled. People taking a serotonin and norepinephrine reuptake inhibitor (SNRI) had a smaller increase in blood pressure, and those taking a selective serotonin reuptake inhibitor (SSRI) had no increase in risk.

This analysis is complicated by the fact that antidepressants are used to treat both anxiety and mood disorders. Depression and low blood pressure may have a common cause or low blood pressure may actually cause depression.

Doctors should consider a patient's blood pressure risk when choosing an antidepressant.

Source: Hypertension, Volume 53, page 631, April 2009

Publication Review By: Karen L. Swartz, M.D.

Published: 20 Aug 2013

Last Modified: 20 Aug 2013