A recent study from St. Michael’s Hospital in Canada has found a possible connection between a common type of blood pressure medicine and a higher risk of suicide.
The research, published in JAMA Network Open, suggests that people who take medications called angiotensin receptor blockers (ARBs) may be more likely to die by suicide than those who take a different kind of blood pressure drug known as ACE inhibitors.
Both ARBs and ACE inhibitors are widely used to treat high blood pressure and other health conditions like heart failure, kidney disease, and diabetes. These medications work by targeting a hormone called angiotensin II, which raises blood pressure by causing blood vessels to narrow.
However, they affect the hormone in different ways. ARBs stop angiotensin II from attaching to receptors in blood vessels, preventing them from tightening. ACE inhibitors, on the other hand, reduce the amount of angiotensin II the body produces.
In the study, researchers looked at health records from across Canada. They focused on 964 people who had died by suicide within 100 days of being prescribed either an ARB or an ACE inhibitor.
Then they compared these cases to a control group of over 3,000 people who were also taking one of the two drugs but had not died by suicide. Their analysis showed that people taking ARBs were 63% more likely to die by suicide than those on ACE inhibitors.
One theory for this finding is that ARBs may affect the brain differently than ACE inhibitors. By blocking the action of angiotensin II in the body, ARBs might cause angiotensin II levels to rise in the brain. This could influence mood and possibly increase the risk of depression or suicidal thoughts.
However, the researchers admit that other factors could be involved, such as whether the individuals were also taking antidepressants or anti-anxiety medications.
Because of these findings, the study’s authors urge caution when prescribing ARBs, especially for people who may already be dealing with mental health issues. They suggest that, when possible, patients who are at higher risk of mood disorders might want to consider taking ACE inhibitors instead.
Still, the researchers stress that more studies are needed to better understand the link between ARBs and suicide risk. This study is an important first step, but it doesn’t prove that ARBs cause suicide. It does, however, raise questions that need further investigation.
Muhammad Mamdani, the lead author and director of the Applied Health Research Center, says that while the results are concerning, they are not final. He and his team believe future research should focus on how these medications affect the brain and mental health over time.
For now, the main message is that people taking blood pressure medication—especially ARBs—should be aware of this potential risk and talk to their doctors if they have any concerns, particularly about their mental well-being.
Patients should never stop taking their medication without medical advice, but they should feel comfortable asking questions and discussing alternatives.
This study is a reminder of how complex the effects of medication can be. While ARBs and ACE inhibitors are effective in treating heart and kidney problems, this research shows that doctors and patients should also consider the possible impact on mental health. Making treatment decisions should always include a full look at the person’s physical and emotional needs.
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