Bojanić Ivana, Bjerkeset Ottar, Williams Lana J, Berk Michael, Sund Erik R, Sletvold Hege
Faculty of Nursing and Health Sciences, Nord University, PB 93, 7601, Levanger, Norway.
Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, NTNU, Trondheim, Norway.
Drugs Real World Outcomes. 2022 Sep;9(3):503-516. doi: 10.1007/s40801-022-00321-7. Epub 2022 Jul 18.
Cardiovascular agents, including angiotensin-converting enzyme inhibitors, angiotensin II receptor inhibitors, acetylsalicylic acid, statins, and metformin, have demonstrated benefits for depression. However, there is scant evaluation of these drugs' antidepressant properties in large population settings.
This study aimed to examine cross-sectional associations between depression symptoms and the use of cardiovascular agents and metformin in populations with cardiovascular diseases or diabetes mellitus.
Participants in the Trøndelag Health Study 2006-08 (HUNT3, n = 40,516) and 2017-19 (HUNT4, n = 42,103) were included and data on their drug use from 2006 to 2019 was retrieved from the Norwegian Prescription Database. The outcome was self-reported depression symptoms defined by the Hospital Anxiety and Depression Scale. Associations between cardiovascular agents or metformin use and self-reported depression were analyzed by multi-level logistic regression in sex-stratified samples.
Among men with cardiovascular diseases, use of acetylsalicylic acid was associated with reduced depression symptoms compared with acetylsalicylic acid non-users (reference) in HUNT3 and HUNT4 [risk ratio = 0.76; 95% confidence interval 0.59-0.94, risk ratio = 0.67; 95% CI 0.52-0.82, respectively]. Similarly, male statin users had a lower likelihood of reporting depression than statin non-users in HUNT3 (risk ratio = 0.70; 95% confidence interval 0.54-0.86) and HUNT4 (risk ratio = 0.67; 95% confidence interval 0.51-0.84). Associations between statins or acetylsalicylic acid use and reduced depression symptoms were detected in women with cardiovascular diseases in HUNT4. We found no statistical support for associations between other cardiovascular agents or metformin use and a reduced or increased depression symptom risk.
Results suggest negative associations between acetylsalicylic acid or statin use and depression symptoms. However, longitudinal cohort studies and randomized controlled trials are required to confirm the antidepressant effects of these drugs.
心血管药物，包括血管紧张素转换酶抑制剂、血管紧张素II受体抑制剂、乙酰水杨酸、他汀类药物和二甲双胍，已显示出对抑郁症有益。然而，在大规模人群中对这些药物的抗抑郁特性评估很少。
本研究旨在探讨抑郁症症状与心血管疾病或糖尿病患者使用心血管药物和二甲双胍之间的横断面关联。
纳入2006 - 2008年特隆赫姆郡健康研究（HUNT3，n = 40516）和2017 - 2019年（HUNT4，n = 42103）的参与者，并从挪威处方数据库中检索他们2006年至2019年的用药数据。结局指标是由医院焦虑抑郁量表定义的自我报告的抑郁症状。在按性别分层的样本中，通过多水平逻辑回归分析心血管药物或二甲双胍使用与自我报告抑郁之间的关联。
在患有心血管疾病的男性中，与未使用乙酰水杨酸的患者（参照）相比，在HUNT3和HUNT4中，使用乙酰水杨酸与抑郁症状减轻相关[风险比分别为0.76；95%置信区间0.59 - 0.94，风险比为0.67；95%置信区间0.52 - 0.82]。同样，在HUNT3（风险比 = 0.70；95%置信区间0.54 - 0.86）和HUNT4（风险比 = 0.67；95%置信区间0.51 - 0.84）中，使用他汀类药物的男性报告抑郁的可能性低于未使用他汀类药物的男性。在HUNT4中，患有心血管疾病的女性中检测到他汀类药物或乙酰水杨酸使用与抑郁症状减轻之间的关联。我们没有发现其他心血管药物或二甲双胍使用与抑郁症状风险降低或增加之间存在关联的统计学依据。
结果表明乙酰水杨酸或他汀类药物使用与抑郁症状之间存在负相关。然而，需要纵向队列研究和随机对照试验来证实这些药物的抗抑郁作用。
