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

TitleAssociation of Antidepressant Medication Type With the Incidence of Cardiovascular Disease in the ARIC Study.
Publication TypeJournal Article
Year of Publication2019
AuthorsAlmuwaqqat Z, Jokhadar M, Norby FL, Lutsey PL, O'Neal WT, Seyerle A, Soliman EZ, Chen LYee, J Bremner D, Vaccarino V, Shah AJ
Secondary AuthorsAlonso A
JournalJ Am Heart Assoc
Volume8
Issue11
Paginatione012503
Date Published2019 06 04
ISSN2047-9980
KeywordsAffect, Aged, Aged, 80 and over, Antidepressive Agents, Antidepressive Agents, Tricyclic, Cardiovascular Diseases, Depression, Female, Humans, Incidence, Male, Middle Aged, Prospective Studies, Risk Assessment, Risk Factors, Serotonin Uptake Inhibitors, Time Factors, United States
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.

DOI10.1161/JAHA.119.012503
Alternate JournalJ Am Heart Assoc
PubMed ID31140335
PubMed Central IDPMC6585369
Grant List16EIA26410001 / AHA / American Heart Association-American Stroke Association / United States
HHSN268201700001I / HL / NHLBI NIH HHS / United States
HHSN268201700003I / HL / NHLBI NIH HHS / United States
HHSN268201700005I / HL / NHLBI NIH HHS / United States
HHSN268201700004I / HL / NHLBI NIH HHS / United States
HHSN268201700002I / HL / NHLBI NIH HHS / United States
K24 MH076955 / MH / NIMH NIH HHS / United States
K24 HL077506 / HL / NHLBI NIH HHS / United States