Blockade of the angiotensin system improves mental health domain of quality of life: A meta-analysis of randomized clinical trials
Year: 2017
Type: review
Study designs: Systematic Review, Meta-Analysis
Abstract: OBJECTIVE: It is unclear whether blockade of the angiotensin system has effects on mental health. Our objective was to determine the impact of angiotensin converting enzyme inhibitors and angiotensin II type 1 receptor (AT1R) blockers on mental health domain of quality of life. STUDY DESIGN: Meta-analysis of published literature. DATA SOURCES: PubMed and clinicaltrials.gov databases. The last search was conducted in January 2017. STUDY SELECTION: Randomized controlled trials comparing any angiotensin converting enzyme inhibitor or AT1R blocker versus placebo or non-angiotensin converting enzyme inhibitor or non-AT1R blocker were selected. Study participants were adults without any major physical symptoms. We adhered to meta-analysis reporting methods as per PRISMA and the Cochrane Collaboration. DATA SYNTHESIS: Eleven studies were included in the analysis. When compared with placebo or other antihypertensive medications, AT1R blockers and angiotensin converting enzyme inhibitors were associated with improved overall quality of life (standard mean difference = 0.11, 95% confidence interval = [0.08, 0.14], p < 0.0001), positive wellbeing (standard mean difference = 0.11, 95% confidence interval = [0.05, 0.17], p < 0.0001), mental (standard mean difference = 0.15, 95% confidence interval = [0.06, 0.25], p < 0.0001), and anxiety (standard mean difference = 0.08, 95% confidence interval = [0.01, 0.16], p < 0.0001) domains of QoL. No significant difference was found for the depression domain (standard mean difference = 0.05, 95% confidence interval = [0.02, 0.12], p = 0.15). CONCLUSIONS: Use of angiotensin blockers and inhibitors for the treatment of hypertension in otherwise healthy adults is associated with improved mental health domains of quality of life. Mental health quality of life was a secondary outcome in the included studies. Research specifically designed to analyse the usefulness of drugs that block the angiotensin system is necessary to properly evaluate this novel psychiatric target.
Institutions: Monash University, Centro de Investigación Biomédica en Red de Salud Mental, Hospital Clínic de Barcelona, Consorci Institut D'Investigacions Biomediques August Pi I Sunyer, Universitat de Barcelona, Universidade Federal do Ceará, King's College London, South London and Maudsley NHS Foundation Trust, Maudsley Hospital, Anglia Ruskin University, University of Lisbon, Centro Hospitalar Lisboa Norte, Parc de Salut, Deakin University, Barwon Health, The University of Texas MD Anderson Cancer Center, Universidade do Extremo Sul Catarinense, The University of Texas Health Science Center at Houston, The University of Melbourne, Florey Institute of Neuroscience and Mental Health, Orygen, Universidade Federal do Rio Grande do Sul
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W2740997385