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(Hypertension. 2009;54:e1.)
© 2009 American Heart Association, Inc.

Letters to the Editor

Depression and Blood Pressure Control: All Antidepressants Are not the Same

Tye Dawood; Markus Schlaich; Alex Brown; Gavin Lambert

Baker IDI Heart and Diabetes Institute, Melbourne and Alice Springs, Australia

An extract of the first 250 words of the full text is provided, because this article has no abstract.

To the Editor:

In their cross-sectional study involving >2900 subjects, Licht et al ¹ demonstrated that depression was associated with reduced blood pressure, whereas the use of certain antidepressants, namely, tricyclic antidepressants ( TCAs) and serotonin-norepinephrine reuptake inhibitors, were associated with higher blood pressure and greater incidence of hypertension. The authors proposed that the link between hypertension and the use of these antidepressants may involve an effect of these agents on vagal tone. Whether antidepressant-induced alteration in vagal function underpins the increase in blood pressure observed by Licht et al ¹ is problematic. We have previously documented a reduction in vagal activity, as indicated by a diminution in heart rate variability and baroreflex sensitivity, in patients with depression after serotonin-specific reuptake inhibitor therapy. ² Moreover, Licht et al, ³ in an earlier analysis of data from the Netherlands Study of Depression and Anxiety, documented a reduction in heart rate variability in patients with depression. The association between diminished heart rate variability and depression was driven largely by the use and dose of antidepressants. Importantly, in the context of interpreting data from their present report, they found that the reduction in heart rate variability was not confined to TCAs and serotonin-norepinephrine reuptake inhibitors but was related to dose across all antidepressant classes, including serotonin-specific reuptake inhibitors. In the present report, serotonin-specific reuptake inhibitors were without an effect on blood pressure.

Activation of the sympathetic nervous system is one of the hallmarks of hypertension. ⁴ We have demonstrated that sympathetic nervous activity in unmedicated patients with depression . . . [Full Text of this Article]

This article has been cited by other articles:

				C. M.M. Licht, B. W.J.H. Penninx, and E. J.C. de Geus Response to Depression and Blood Pressure Control: All Antidepressants Are not the Same Hypertension, July 1, 2009; 54(1): e2 - e2. [Full Text] [PDF]