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Cited by 42Cardiac Health and Mental HealthTreatment of Major DepressionBlood Pressure and Hypertension Studies

Association of Antidepressant Medication Type With the Incidence of Cardiovascular Disease in the ARIC Study

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Almuwaqqat, Zakaria, Jokhadar, Maan, Norby, Faye L., Lutsey, Pamela L., O'Neal, Wesley T., Seyerle, Amanda, Soliman, Elsayed Z., Chen, Lin Y. +4 more·2019·Journal of the American Heart Association
DOI 10.1161/jaha.119.012503PMC PMC6585369
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Abstract

Background: The association of antidepressant medication type with the risk of cardiovascular disease ( CVD ) is unclear. We hypothesized that selective serotonin reuptake inhibitors ( SSRI s) are associated with lower risks of CVD events relative to tricyclics and other non‐ SSRI antidepressants. Methods and Results: We studied 2027 participants from the ARIC (Atherosclerosis Risk in Communities) study (mean age 63±10 years; 29% men; 78% white) treated with antidepressants at some time between 1987 and 2013. Antidepressant usage was confirmed by participants bringing pill bottles to study visits. CVD events in the study sample were identified, including atrial fibrillation, heart failure, myocardial infarction, and ischemic stroke. Hazard ratios were used to compare CVD events adjusted for sociodemographic and clinical risk factors in SSRI s users (47%) versus non‐ SSRI users. Participants were followed from antidepressant initiation up to 2016 for a median of 13.5 years. We identified 332 atrial fibrillation, 365 heart failure, 174 myocardial infarction and 119 ischemic stroke events. CVD risk was similar for SSRI s and non‐ SSRI antidepressant users (hazard ratio, 1.10; 95% CI , 0.86–1.41 for atrial fibrillation; hazard ratio, 0.98; 95% CI, 0.77–1.25 for heart failure; hazard ratio, 0.91; 95% CI , 0.64–1.29 for myocardial infarction; and hazard ratio, 1.07; 95% CI , 0.70–1.63 for ischemic stroke). Conclusions: SSRI use was not associated with reduced risk of incident CVD compared with non‐ SSRI antidepressant use. These results do not provide evidence supporting the use of SSRI s compared with tricyclics and other non‐ SSRI antidepressants in relation to CVD risk.

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Authors
Almuwaqqat, Z., Jokhadar, M., Norby, F. L., Lutsey, P. L., O'Neal, W. T., Seyerle, A., Soliman, E. Z., Chen, L. Y., Bremner, J. D., Vaccarino, V., Shah, A. J., & Alonso, A.
Affiliations
  • Emory University (US)
  • University of Minnesota (US)
  • Division of Cardiology Department of Medicine Emory University School of Medicine Atlanta GA
  • University of North Carolina at Chapel Hill (US)
  • Wake Forest University Health Sciences (US)
  • Department of Epidemiology Rollins School of Public Health Emory University Atlanta GA
Corresponding author
Almuwaqqat, Zakaria
ORCID
Venue
Journal of the American Heart Association
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2019-06-04
Volume
8
Issue
11
Pages
e012503-e012503
ISSN
2047-9980 (ISSN-L)
DOI
10.1161/jaha.119.012503
PMC
PMC6585369
OpenAlex
W2946966201
Cited by
42
References
3
Citations by year
2026: 6 · 2025: 7 · 2024: 6 · 2023: 4 · 2022: 7 · 2021: 6 · 2020: 3 · 2019: 3
FWCI
3.43
Type
journal article
Language
en
Open access
Licence
cc-by-nc
Locations
  • Journal of the American Heart Association (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
Funders
  • American Heart Association (16EIA26410001)
  • National Heart, Lung, and Blood Institute (HHSN268201700004I, HHSN268201700001I, HHSN268201700003I, HHSN268201700005I, K24HL077506, HHSN268201700002I)
  • National Institute of Mental Health (K24MH076955)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
  • Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
Keywords
antidepressants, cardiovascular disease, selective serotonin reuptake inhibitors, tricyclic antidepressants, atrial fibrillation, heart failure, myocardial infarction, ischemic stroke, cardiovascular risk, Atherosclerosis Risk in Communities Study
MeSH terms
Affect, Aged, Aged, 80 and over, Antidepressive Agents, Antidepressive Agents, Tricyclic, Cardiovascular Diseases, Depression, Female, Humans, Male, Middle Aged, Prospective Studies, Risk Factors, Time Factors, United States, Incidence, Selective Serotonin Reuptake Inhibitors, Risk Assessment

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