U.S. researchers link antidepressants with thicker arteries

Published: 04/04/2011 05:00

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People taking antidepressants may be more
likely to develop thicker arteries which may raise the risk of heart disease and
stroke, a new study suggests.


Depression can heighten the risk for heart
disease, but the effect of antidepressant use is separate and independent from
depression itself, according to the study make public by the American
Association for the Advancement of Science (AAAS) on Saturday.


The data suggest that antidepressants may combine
with depression for a negative effect on blood vessels, said study first author
Amit Shah, MD, a cardiology fellow at Emory University School of Medicine.


Study findings will be presented on April 5 at
the American College of Cardiology meeting in New Orleans, according to the
AAAS.


The study included 513 middle-aged male twins who
both served in the U.S. military during the Vietnam War. Twins are genetically
the same but may be different when it comes to other risk factors such as diet,
smoking and exercise, so studying them is a good way to distill out the effects
of genetics.


Researchers measured carotid intima-media
thickness - the thickness of the lining of the main arteries in the neck — by
ultrasound. Among the 59 pairs of twins where only one brother took
antidepressants, the one taking the drugs tended to have higher carotid intima-media
thickness (IMT), even when standard heart disease risk factors were taken into
account.


The effect was seen both in twins with or without
a previous heart attack or stroke. A higher level of depressive symptoms was
associated with higher IMT only in those taking antidepressants.


“One of the strongest and best-studied factors
that thickens someone’s arteries is age, and that happens at around 10 microns
per year,” Shah said. “In our study, users of antidepressants see an average 40
micron increase in IMT, so their carotid arteries are in effect four years
older.”


Antidepressants’ effects on blood vessels may
come from changes in serotonin, a chemical that helps some brain cells
communicate but also functions outside the brain, Shah said.


“I think we have to keep an open mind about the
effects of antidepressants on neurochemicals like serotonin in places outside
the brain, such as the vasculature. The body often compensates over time for
drugs’ immediate effects,” Shah said. ” Antidepressants have a clinical benefit
that has been established, so nobody taking these medications should stop based
only on these results. This isn ’t the kind of study where we can know cause and
effect, let alone mechanism, and we need to see whether this holds up in other
population groups.”


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