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Antihypertensive treatment and adverse psychiatric reactions in primary health care

Curic, Emina LU orcid ; Ohlsson, Henrik LU ; Kendler, Kenneth K ; Sundquist, Jan LU ; Sundquist, Kristina LU ; Reis, Margareta LU and Zöller, Bengt LU orcid (2026) In Journal of Human Hypertension p.1-8
Abstract
Antihypertensive treatment (AHT) has been associated with adverse psychiatric reactions (APRs), but existing data are conflicting. The aim of the present study was to determine the risk for seven different APRs in drug-naive patients with newly diagnosed hypertension in primary health care. This cohort study analyzed registry data of individuals aged 40–70 with a newly diagnosed untreated hypertension without previous psychiatric or cardiovascular comorbidities in Swedish primary healthcare from 2006 and onwards. Adjusted Cox proportional hazard ratios (aHRs) with 95% confidence intervals (CIs) were estimated with seven different AHTs as time-dependent variables. Seven different APRs outcomes were studied. Bonferroni correction was used.... (More)
Antihypertensive treatment (AHT) has been associated with adverse psychiatric reactions (APRs), but existing data are conflicting. The aim of the present study was to determine the risk for seven different APRs in drug-naive patients with newly diagnosed hypertension in primary health care. This cohort study analyzed registry data of individuals aged 40–70 with a newly diagnosed untreated hypertension without previous psychiatric or cardiovascular comorbidities in Swedish primary healthcare from 2006 and onwards. Adjusted Cox proportional hazard ratios (aHRs) with 95% confidence intervals (CIs) were estimated with seven different AHTs as time-dependent variables. Seven different APRs outcomes were studied. Bonferroni correction was used. Among 677,564 studied individuals (51% female, mean age [±standard deviation] 58.0 [ ± 7.7] years), the highest risks of APRs occurred within the first two years of AHT. All AHTs were associated with one or more APRs. Beta-blockers showed strongest associations with APR. During the first two years after diagnosis of hypertension, beta-blockers were significantly associated with substance abuse disorders (aHR=1.48, 95%CI 1.43-1.54), psychotic disorders (aHR=1.46, 95%CI 1.27-1.68), affective disorders (aHR=1.35, 95%CI 1.32-1.39), bipolar disorders (aHR=1.34, 95%CI 1.12-1.61), depressive disorders (aHR=1.36, 95%CI 1.32-1.40), anxiety disorders (aHR=1.51, 95%CI 1.48-1.54), and sleep disorders (aHR=1.27, 95%CI 1.24-1.30). Certain associations remained in a co-sibling analysis. AHTs are associated with several APRs especially during the first two years after diagnosis of hypertension. However, it is important to note that only association but not causality can be inferred due to persistent confounding that could not be practically adjusted for. (Less)
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author
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organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Journal of Human Hypertension
pages
1 - 8
publisher
Nature Publishing Group
external identifiers
  • pmid:42660983
  • scopus:105048522540
ISSN
1476-5527
DOI
10.1038/s41371-026-01212-y
language
English
LU publication?
yes
id
4f549f78-9220-47f4-ac7e-4f2e4f221bfa
date added to LUP
2026-09-07 08:47:18
date last changed
2026-09-08 04:00:47
@article{4f549f78-9220-47f4-ac7e-4f2e4f221bfa,
  abstract     = {{Antihypertensive treatment (AHT) has been associated with adverse psychiatric reactions (APRs), but existing data are conflicting. The aim of the present study was to determine the risk for seven different APRs in drug-naive patients with newly diagnosed hypertension in primary health care. This cohort study analyzed registry data of individuals aged 40–70 with a newly diagnosed untreated hypertension without previous psychiatric or cardiovascular comorbidities in Swedish primary healthcare from 2006 and onwards. Adjusted Cox proportional hazard ratios (aHRs) with 95% confidence intervals (CIs) were estimated with seven different AHTs as time-dependent variables. Seven different APRs outcomes were studied. Bonferroni correction was used. Among 677,564 studied individuals (51% female, mean age [±standard deviation] 58.0 [ ± 7.7] years), the highest risks of APRs occurred within the first two years of AHT. All AHTs were associated with one or more APRs. Beta-blockers showed strongest associations with APR. During the first two years after diagnosis of hypertension, beta-blockers were significantly associated with substance abuse disorders (aHR=1.48, 95%CI 1.43-1.54), psychotic disorders (aHR=1.46, 95%CI 1.27-1.68), affective disorders (aHR=1.35, 95%CI 1.32-1.39), bipolar disorders (aHR=1.34, 95%CI 1.12-1.61), depressive disorders (aHR=1.36, 95%CI 1.32-1.40), anxiety disorders (aHR=1.51, 95%CI 1.48-1.54), and sleep disorders (aHR=1.27, 95%CI 1.24-1.30). Certain associations remained in a co-sibling analysis. AHTs are associated with several APRs especially during the first two years after diagnosis of hypertension. However, it is important to note that only association but not causality can be inferred due to persistent confounding that could not be practically adjusted for.}},
  author       = {{Curic, Emina and Ohlsson, Henrik and Kendler, Kenneth K and Sundquist, Jan and Sundquist, Kristina and Reis, Margareta and Zöller, Bengt}},
  issn         = {{1476-5527}},
  language     = {{eng}},
  month        = {{08}},
  pages        = {{1--8}},
  publisher    = {{Nature Publishing Group}},
  series       = {{Journal of Human Hypertension}},
  title        = {{Antihypertensive treatment and adverse psychiatric reactions in primary health care}},
  url          = {{http://dx.doi.org/10.1038/s41371-026-01212-y}},
  doi          = {{10.1038/s41371-026-01212-y}},
  year         = {{2026}},
}