Angiotensin receptor blockers (ARBs) and ACE inhibitors are commonly used to treat high blood pressure, chronic kidney disease, heart failure, and diabetes.
They both work by interfering with the action of angiotensin II, a hormone in the body that causes blood vessels to constrict.
ARBs work by blocking the ability of angiotensin II to bind with receptors and command blood vessels to narrow, while ACE inhibitors actually lower the amount of the hormone produced within the body.
In a recent study from St. Michael’s Hospital, researchers found people taking ARBs appear to be more likely to die by suicide, compared to those who take CE inhibitors.
The study is published in JAMA Network Open. The lead author is Muhammad Mamdani, director of the Applied Health Research Center.
In the study, the team used Canadian health databases to identify 964 people who died by suicide within 100 days of being prescribed either an ARB or an ACE inhibitor.
They then compared those people to a control group of just over 3,000 people also taking either type of blood pressure medication.
The results showed that people taking ARBs had a much higher risk of suicide than those on an ACE inhibitor.
Patients using ARBs had a 63% increased risk of death by suicide over people on ACE inhibitors.
The team says that ARBs might cause levels of angiotensin II to increase in the brain. That could be related to mood disorders, and that could trigger suicidal-type behavior.
Other factors that could influence suicide risk might have come into play with these patients. For example, some were taking antidepressants or benzodiazepines.
The team says there is a reason for some concern but they need to have more work to test the finding.
They suggest patients may want to choose the ACE inhibitor over the ARB.
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