Effects of Selective Serotonin Reuptake Inhibitor Treatment on Blood Pressure in Resistant Hypertensive Patients with Anxiety Disorder

INTRODUCTION: This study aimed to evaluate the effects of selective serotonin reuptake inhibitor (SSRI) treatment on blood pressure (BP) control in resistant hypertensive patients with anxiety symptoms.
METHODS: This interventional study was conducted between January 2021 and March 2022 at a family medicine outpatient clinic. Patients with primary hypertension (HT), uncontrolled with monotherapy, and scoring ≥16 on the Beck anxiety inventory were included. All were switched to combination antihypertensive therapy. Those who accepted SSRI treatment constituted the case group, while those who declined formed the control group. Demographic and clinical characteristics were recorded. BP was measured at baseline and after 1 month.
RESULTS: Ninety-one patients were included, 30 (33.0%) male, the median age was 53.5 (35.0–68.0) years. Of the participants, 72 (79.1%) received combined therapy plus SSRI, while 19 (20.9%) received combined therapy only. After 1 month, systolic BP decreased by 15.0 (1.0–22.0) mmHg and diastolic BP by 13.0 (4.0–18.0) mmHg in the case group, compared to decreases of 8.0 (1.0–17.0) mmHg and 6.0 (2.0–13.0) mmHg in the control group (respectively, p<0.001 and p<0.001).
DISCUSSION AND CONCLUSION: SSRI therapy provided significantly greater reductions in both systolic and diastolic BP compared with combination antihypertensive treatment alone. Anxiety should be considered an important factor in resistant HT, and psychological as well as pharmacological interventions may enhance treatment outcomes.