Relationship between selective serotonin reuptake inhibitors and hypertension

Background: Selective serotonin reuptake inhibitors are widely used to treat major depressive disorder. Recent evidence suggests SSRIs may also have beneficial effects on cardiovascular health, particularly blood pressure regulation, in patients with comorbid major depressive disorder and hypertension. However, findings have been mixed. Objectives: To determine if SSRI treatment provides antihypertensive effects beyond mood improvements among major depressive disorder patients with concurrent hypertension, and to explore potential mediating roles of changes in psychosocial factors. Material and Methods: Matched interventional study with 25 MDD patients with comorbid hypertension initiated on SSRIs, compared to 25 patients on non-SSRI antidepressants. Resting blood pressure and responses on a psychiatric questionnaire assessing depression, anxiety, sleep, stress, health behaviors, and mental health were evaluated over 6 months between groups. Results: Selective Serotonin Reuptake Inhibitors group exhibited significant reductions in systolic blood pressure (-8.4 mmHg) versus the non-SSRI group (-5.6 mmHg), along with dramatic improvements in depression, anxiety, sleep quality, treatment adherence, lifestyle modifications, and overall mental health (all p<0.05). Conclusion: SSRIs demonstrate meaningful incremental blood pressure-lowering effects in hypertensive patients with MDD, likely mediated in part by broader enhancements across psychosocial spheres facilitating better cardiovascular health.