The association between antihypertensive medications and mental health outcomes among Syrian war refugees with stress and hypertension

• Published in: Journal of psychosomatic research Vol. 168; p. 111200
• Main Authors: Gammoh, Omar, Bjørk, Marte-Helene, Al Rob, Osama Abo, AlQudah, Abdel Rahim, Hani, Amjad Bani, Al-Smadi, Ahmed
• Format: Journal Article
• Language: English
• Published: England Elsevier Inc 01.05.2023
• Subjects: Angiotensin Receptor Antagonists - therapeutic use; Angiotensin-Converting Enzyme Inhibitors - therapeutic use; Antihypertensive Agents - adverse effects; Anxiety; Cross-Sectional Studies; Depression; Female; Humans; Hypertension; Hypertension - drug therapy; Hypertension - epidemiology; Insomnia; Male; Outcome Assessment, Health Care; Psychiatric/Mental Health; PTSD; Refugees - psychology; Sleep Initiation and Maintenance Disorders - drug therapy; Stress Disorders, Post-Traumatic - drug therapy; Syria; β-Blockers; Syria; Hypertension; PTSD; Depression; Anxiety; Insomnia; β-Blockers
• ISSN: 0022-3999; 1879-1360; 1879-1360
• DOI: 10.1016/j.jpsychores.2023.111200

Little is known about the association between antihypertensive drugs with mental health outcomes. We examined the association between the antihypertensive classes and other clinical patient features with symptoms of depression, anxiety, insomnia, and Post-Traumatic Stress Disorder (PTSD) in a cohort of Syrian war refugees with stress and hypertension residing in Jordan. This cross-sectional study recruited hypertensive Syrian refugees with stress. Depression severity was assessed using the Patient Health Questionnaire-9, anxiety was measured by The General Anxiety Disorder-7, the Insomnia Severity Index was used to evaluate sleep quality and PTSD was measured using Davidson Trauma Scale. To investigate the association between the different classes of antihypertensive medication and mental health outcomes we used multivariable regression models. Of the 492 participants, 251 were men (51%), 234 (47.6%) were on β-blockers, 141 (28.7%) on diuretics, and 209 (42.5%) on Angiotensin Converting Enzyme Inhibitors (ACEIs)/Angiotensin Receptor Blockers (ARBs). Although the multivariate regression revealed the different classes of antihypertensives are not associated with mental health symptoms, however, physical activity is associated with lower adjusted odds for symptoms of depression (0.68 (0.46–0.99), p = 0.04), anxiety (0.60 (0.42–0.85),p = 0.005), insomnia (0.63 (0.44–0.91),p = 0.01) and dyslipidemia (3.48(0.29–6.69),p = 0.03) is associated with higher PTSD symptoms. The study subjects were not assessed for psychiatric diagnoses clinically. Further, we used a cross-sectional design that does not allow to measure longitudinal changes. The association between antihypertensive drugs and mental health symptoms was not evident in the present study. Follow-up future studies are required. •Mental health of hypertensive war refugees is often overlooked.•Antihypertensive medications and lifestyle could affect mental health symptoms•The antihypertensive medications were not associated with mental health symptoms.•Close monitoring of mental health is required for this fragile population