Blood pressure medications are among the most commonly prescribed medications in the world. Millions of people take them every day to protect their heart, kidneys and blood vessels.
These medications are generally considered safe and effective, and for most people they are. However, a new study has raised concerns about a possible link between one type of blood pressure medication and an increased risk of suicide.
The study was conducted by researchers at St. Michael’s Hospital in Canada and was published in the medical journal JAMA network opened.
The researchers focused on two commonly used types of blood pressure medications: angiotensin receptor blockers, known as ARBs, and angiotensin-converting enzyme inhibitors, known as ACE inhibitors.
Both medications are commonly prescribed for high blood pressure, heart failure, chronic kidney disease and diabetes.
These two types of medications work on the same hormone system in the body, the renin-angiotensin system.
This system helps control blood pressure by tightening or relaxing the blood vessels. A hormone called angiotensin II plays a key role. If there is too much angiotensin II, the blood vessels constrict and blood pressure rises.
ACE inhibitors lower blood pressure by reducing the amount of angiotensin II the body produces, while ARBs work differently.
Instead of reducing the hormone, they prevent it from attaching to the blood vessels, causing the blood vessels to stop constricting. Both approaches lower blood pressure, but they affect the body in slightly different ways.
To investigate whether these differences might matter for mental health, the researchers examined large Canadian health databases. They looked at 964 people who died by suicide within 100 days of starting an ARB or an ACE inhibitor.
These individuals were compared to more than 3,000 similar patients who took the same types of medications but did not die by suicide.
After carefully comparing the two groups, the researchers found a troubling pattern. People taking ARBs had a 63 percent higher risk of suicide than those taking ACE inhibitors.
This finding persisted even after the researchers adjusted for age, gender and other health conditions.
The research does not prove that ARBs cause suicide, but does suggest that there may be a link that deserves further attention.
One possible explanation is the way these drugs affect the brain. Angiotensin II not only works in the heart and blood vessels. It is also active in the brain, where it can influence mood, stress and emotional regulation.
The researchers believe that blocking angiotensin II in the body with ARBs could lead to higher levels of this hormone in the brain.
Increased angiotensin II activity in the brain has been linked to anxiety, depression and stress responses in previous research. This could potentially increase the risk of suicidal thoughts in vulnerable people.
The study’s lead author, Muhammad Mamdani, emphasized that this research is an early warning and not a definitive answer.
He explained that patients should not stop taking their blood pressure medications based on this study alone. Stopping medication suddenly can be dangerous and may increase the risk of heart attack or stroke.
