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Abstract: PO2079

Effect of Psychiatric Diagnosis and Selective Serotonin Reuptake Inhibitors (SSRIs)/Serotonin Norepinephrine Reuptake Inhibitors (SNRIs) Use on BP Using 24-Hour Ambulatory Blood Pressure Monitoring (ABPM)

Session Information

Category: Hypertension and CVD

  • 1401 Hypertension and CVD: Epidemiology, Risk Factors, and Prevention

Authors

  • Aslam, Nabeel, Mayo Clinic, Jacksonville, Florida, United States
  • Memon, Sobia Hassan, Mayo Clinic, Jacksonville, Florida, United States
  • Wadei, Hani, Mayo Clinic, Jacksonville, Florida, United States
  • Niazi, Shehzad K., Mayo Clinic, Jacksonville, Florida, United States
Background

Hypertension (HTN) and psychiatric disorders frequently co-exist.Psychiatric conditions and their treatment by SSRIs/SNRIs affect serotonin & norepinephrine and may cause variation in blood pressure (BP).There is limited data to assess this variation by using ABPM.

Methods

Subjects who underwent psychiatric evaluation & ABPM within six month of each other between 1/2012 to 12/2017 were identified.Demographics, co-morbidities, medications, ABPM, lab data were retrospectively collected.Subjects were divided into group–subjects with no psychiatric diagnosis & no psychiatric medicine(Group 1),subjects with psychiatric diagnosis & on SSRIs/SNRIs(Group 2) and subjects with psychiatric diagnosis & on no medication(Group 3).BP systolic & diastolic levels(daytime, nighttime) were compared between groups controlling for age, sex, race, HTN, DM and smoking.Single and multivariable linear regression models were used to analyze group differences.

Results

Total of 475 subjects met inclusion criteria–Group 1=135,Group2=232, and Group3=108. First, Group 1 was compared with Group 2 for daytime systolic & diastolic, nighttime systolic & diastolic BP.In multivariable analysis adjusted for age, sex, race,HTN, DM, and smoking, subjects in Group 2 had higher nighttime systolic BP(122.7vs110.5 mm;β 8.36; 95%CI 4.21,12.51;P<0.0001) and nighttime diastolic BP(68.2vs63.4 mm;β 4.6;CI1.92,7.29;P=0.001).To determine whether higher nighttime systolic & diastolic BP in Group 2 were due to psychiatric diagnosis or effect of SSRIs/SNRIs, we compared ABPM between Group1 & Group3.In adjusted model,there was no statistically significant difference between Group 1 & 3 for daytime or nighttime systolic or diastolic BP suggesting higher nighttime BP in Group 2 was associated with SSRIs/SNRIs use.

Conclusion

In this single center retrospective study, use of SSRIs/SNRIs was associated with significantly higher nocturnal systolic & diastolic BP among subjects with psychiatric diagnosis using SSRIs/SNRIs.This may be due to ongoing sympathetic activation during sleep with serotonin & norepinephrine with SRRIs/SNRIs use.Further prospective studies using ABPM are needed to determine the risk of nocturnal hypertension with SSRIs/SNRIs use that could adversely impact cardiovascular outcomes.