title: Beta-blockers and depression in elderly hypertension patients in primary care.
abstract: OBJECTIVE
  Previous findings regarding a possible association between beta-blocker use and depression are mixed. To our knowledge there have been no studies investigating the association of beta-blockers with depression in primary care hypertension patients without previous myocardial infarction. The aim of this study was to determine the relation between lipophilic beta-blocker use and depression in elderly primary care patients with hypertension.
  
  
  METHODS
  This was a cross-sectional study in primary care practices located in the South of The Netherlands. Primary care hypertension patients without previous myocardial infarction or heart failure (n=573), aged between 60 and 85 years (mean age=70±6.6), were included. All patients underwent a structured interview that included a self-report questionnaire to assess depression (PHQ-9), which was divided in four groups (PHQ-9 score of 0, 1--3, 4--8, 9 or higher).
  
  
  RESULTS
  A PHQ-9 score of 0 was more prevalent in non-beta-blocker users versus lipophilic beta-blocker users (46% versus 35%), a PHQ-9 score of 4--8 was less prevalent in non-beta-blocker users as compared with lipophilic beta-blocker users (14% versus 25%). A chi-squared test showed that lipophilic beta-blocker users as compared to non-beta-blockers users were more likely to be in a higher depression category. Ordinal regression showed a significant relationship between use of lipophilic beta-blockers and depression (OR=1.60, 95% CI=1.08--2.36) when adjusting for potential confounders.
  
  
  CONCLUSIONS
  Our findings show that primary care hypertension patients who use a lipophilic beta-blocker are more likely to have higher depression scores than those who do not use a lipophilic beta-blocker.
authors.affiliation: Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands.
authors.forename: Lianne
authors.initials: L
authors.lastname: Ringoir
authors.forename: Susanne S
authors.initials: SS
authors.lastname: Pedersen
authors.forename: Jos W M G
authors.initials: JW
authors.lastname: Widdershoven
authors.forename: Francois
authors.initials: F
authors.lastname: Pouwer
authors.forename: Josephine M L
authors.initials: JM
authors.lastname: Keyzer
authors.forename: Arnold C
authors.initials: AC
authors.lastname: Romeijnders
authors.forename: Victor J M
authors.initials: VJ
authors.lastname: Pop
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000009:adverse effects* / Q000145:classification / Q000627:therapeutic use; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000009:adverse effects* / Q000145:classification / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D003863:Depression / Q000139:chemically induced*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D019338:Polypharmacy; D011320:Primary Health Care; D012737:Sex Factors; D012959:Socioeconomic Factors
chemical_list: D000319:Adrenergic beta-Antagonists; D000959:Antihypertensive Agents