Blood pressure medicines are among the most commonly prescribed drugs in the world. Millions of people take them every day to protect their hearts, kidneys, and blood vessels.
These medicines are usually seen as 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 carried out by researchers at St. Michael’s Hospital in Canada and was published in the medical journal JAMA Network Open.
The researchers focused on two widely used types of blood pressure drugs: angiotensin receptor blockers, known as ARBs, and angiotensin-converting enzyme inhibitors, known as ACE inhibitors. Both drugs are commonly prescribed for high blood pressure, heart failure, chronic kidney disease, and diabetes.
These two types of medication work on the same hormone system in the body, called the renin-angiotensin system. This system helps control blood pressure by tightening or relaxing blood vessels. A hormone called angiotensin II plays a key role. When there is too much angiotensin II, blood vessels narrow, and blood pressure rises.
ACE inhibitors lower blood pressure by reducing how much angiotensin II the body makes. ARBs work differently. Instead of reducing the hormone, they block it from attaching to blood vessels, stopping the vessels from tightening. Both approaches lower blood pressure, but they affect the body in slightly different ways.
To explore 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 either an ARB or an ACE inhibitor.
These individuals were compared with more than 3,000 similar patients who were taking the same types of medication but did not die by suicide.
After carefully comparing the two groups, the researchers found a concerning pattern. People taking ARBs had a 63 percent higher risk of suicide than those taking ACE inhibitors. This finding remained even after the researchers adjusted for age, sex, and other health conditions.
The study does not prove that ARBs cause suicide, but it suggests there may be a connection that deserves closer attention. One possible explanation involves how these drugs affect the brain. Angiotensin II does not only work in the heart and blood vessels. It is also active in the brain, where it may influence mood, stress, and emotional regulation.
The researchers believe that blocking angiotensin II in the body with ARBs might lead to higher levels of this hormone in the brain. Increased angiotensin II activity in the brain has been linked in earlier research to anxiety, depression, and stress responses. This could potentially increase the risk of suicidal thoughts in vulnerable individuals.
The study also notes that some patients in the analysis were taking other medications, such as antidepressants or benzodiazepines, which are often used to treat anxiety and sleep problems. These drugs could have influenced the results. Mental health history, life stress, and social factors were also not fully captured in the data.
Because of these limitations, the researchers stress that more studies are needed. Larger and longer studies could help confirm whether the link is real and explain how it might work. Laboratory research may also help scientists understand what ARBs do in the brain and how that could affect mood.
The lead author of the study, Muhammad Mamdani, emphasized that this research is an early warning, not a final answer. He explained that patients should not stop taking their blood pressure medication based on this study alone. Stopping medication suddenly can be dangerous and may increase the risk of heart attack or stroke.
Instead, the findings highlight the importance of personalized medical care. For patients who have a history of depression, anxiety, or suicidal thoughts, doctors may want to think carefully about which blood pressure medicine to prescribe. In some cases, choosing an ACE inhibitor instead of an ARB may be worth discussing.
This study also shows how closely physical health and mental health are connected. Medicines designed to protect the heart may also affect the brain in ways that are not always obvious. Understanding these connections can help doctors provide safer and more effective treatment.
Patients who are taking ARBs or are about to start them should not panic. These medicines help many people live longer and healthier lives.
However, anyone experiencing mood changes, depression, or troubling thoughts should talk to their doctor right away. Open communication can help ensure that treatment supports both physical and mental well-being.
If you care about high blood pressure, please read studies that early time-restricted eating could help improve blood pressure, and natural coconut sugar could help reduce blood pressure and artery stiffness.
For more health information, please see recent studies about added sugar in your diet linked to higher blood pressure, and results showing vitamin D could improve blood pressure in people with diabetes.
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