Key result
Escitalopram lowers heart rate by ~7 bpm vs placebo without reducing blood pressure.
Why the study?
The effects of escitalopram on blood pressure and heart rate in individuals with hypertension and depression were not well established.
Does escitalopram reduce blood pressure and heart rate in individuals with hypertension and depression?
RCT (n=30)
Does escitalopram reduce blood pressure and heart rate in individuals with hypertension and depression?
Absolute Event Rate: 66.79% vs 74.1%
p-value: p=0.044
Escitalopram significantly reduces heart rate but does not affect blood pressure in patients with hypertension and major depression.
Does not support escitalopram as antihypertensive adjunct; extends evidence on its selective heart rate effects in comorbid depression.
OBJECTIVE: To test the role of escitalopram on blood pressure and heart rate of individuals with hypertension and depression. METHODS: A total of 30 individuals participated in this study who were being treated for hypertension and were diagnosed with major depression. Escitalopram (10-20 mg) was administered to 15 individuals, while the other 15 received placebo. These individuals were followed for 8 weeks with regular monitoring of blood pressure and heart rate. Scores on the Hamilton Depression Rating Scale were evaluated within the first, second, fourth, and eighth weeks of the study onset. RESULTS: Comparing with placebo, heart rate was lower in the escitalopram group (66.79 ± 9.85 vs. 74.10 ± 9.52 bpm, p = 0.044). There was not a significant decrease of systolic blood pressure (140.80 ± 16.48 vs 139.61 ± 18.92 mmHg, p = 0.85) and diastolic blood pressure (80.55 ± 12.64 vs 80.18 ± 16.36 mmHg, p = 0.94). CONCLUSION: Escitalopram decreases HR, but not BP, in individuals with hypertension and depression. Abbreviation: SH: systemic hypertension; BP: blood pressure; DSM: Diagnostic and Statistical Manual of Mental Disorders; SRQ 20: Self-Report Questionnaire; SCID: Structured Clinical Interview for DSM-IV; HR: heart rate; SNS: Sympathetic nervous system; HPA: hypothalamus-pituitary-adrenal axis; RAA: renin, angiotensin, aldosterone system; NE: norepinephrine; CSF: cerebrospinal fluid; HAM-D: Hamilton Depression Rating Scale; CRF: corticotropin releasing factor; ACTH: adrenocorticotropic hormone; BMI: Body mass index; SBP: systolic blood pressure; DBP: diastolic blood pressure; t: time.
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Peixoto et al. (2018) conducted an RCT in Hypertension and major depression (n=30). Escitalopram vs. Placebo was evaluated on Heart rate (p=0.044). Escitalopram significantly lowered heart rate compared to placebo (66.79 vs 74.10 bpm; p=0.044) but did not reduce blood pressure in patients with hypertension and major depression.
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