Hypertension, cardiovascular diseases, and cerebrovascular diseases are associated with an increased risk of depression, but it remains unclear whether treatment with antihypertensive agents decreases or increases this risk. The effects of individual drugs are also unknown. We used Danish population-based registers to systematically investigate whether the 41 most used individual antihypertensive drugs were associated with an altered risk of incident depression. Analyses of diuretics were included for comparisons. Participants were included in the study in January 2005 and followed until December 2015. Two different outcome measures were included: (1) a diagnosis of depressive disorder at a psychiatric hospital as an inpatient or outpatient and (2) a combined measure of a diagnosis of depression or use of antidepressants. Continued use of classes of angiotensin agents, calcium antagonists, and β-blockers was associated with significantly decreased rates of depression, whereas diuretic use was not. Individual drugs associated with decreased depression included 2 of 16 angiotensin agents: enalapril and ramipril; 3 of 10 calcium antagonists: amlodipine, verapamil, and verapamil combinations; and 4 of 15 β-blockers: propranolol, atenolol, bisoprolol, and carvedilol. No drug was associated with an increased risk of depression. In conclusion, real-life population-based data suggest a positive effect of continued use of 9 individual antihypertensive agents. This evidence should be used in guiding prescriptions for patients at risk of developing depression including those with prior depression or anxiety and patients with a family history of depression.

中文翻译：

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抗高血压药物和抑郁风险

高血压、心血管疾病和脑血管疾病与抑郁风险增加有关，但目前尚不清楚抗高血压药物治疗是否会降低或增加这种风险。个别药物的作用也是未知的。我们使用丹麦基于人群的登记册来系统地调查 41 种最常用的抗高血压药物是否与发生抑郁症的风险改变有关。包括利尿剂的分析以进行比较。参与者于 2005 年 1 月被纳入研究，并持续到 2015 年 12 月。包括两种不同的结果测量：（1）在精神病院作为住院患者或门诊患者的抑郁症诊断和（2）对抑郁症诊断的综合测量抑郁症或使用抗抑郁药。继续使用各类血管紧张素药物、钙拮抗剂和 β 受体阻滞剂与抑郁症发生率显着降低相关，而利尿剂的使用则不然。与抑郁症减轻相关的个别药物包括 16 种血管紧张素药物中的 2 种：依那普利和雷米普利；10 种钙拮抗剂中的 3 种：氨氯地平、维拉帕米和维拉帕米组合；和 15 种 β 受体阻滞剂中的 4 种：普萘洛尔、阿替洛尔、比索洛尔和卡维地洛。没有药物与抑郁症风险增加有关。总之，基于真实人群的数据表明，继续使用 9 种抗高血压药物会产生积极影响。该证据应用于指导有患抑郁症风险的患者的处方，包括既往患有抑郁症或焦虑症的患者以及有抑郁症家族史的患者。