Serotonin and norepinephrine reuptake inhibitors antidepressant use is related to lower baroreflex sensitivity independently of the severity of depressive symptoms. A community-study of 9213 participants from the Paris Prospective Study III.
We assess the respective relationship of high depressive symptoms and antidepressant use (ATD) with baroreflex sensitivity (BRS) in subjects from the community who enrolled the Paris Prospective Study III.



Recruitment took place in a large health preventive centre in Paris (France), between May 2008 and June 2012. BRS was investigated by spectral analysis of the spontaneous carotid distension rate and RR intervals using non-invasive high-resolution ultrasound carotid-echotracking. A total score ≥7 on a 13-item standardized questionnaire defined the presence of high depressive symptoms. Information on ATD use was obtained on a face-to-face interview with a medical doctor who checked the most recent medical prescriptions and/or medical package.



There were 9213 participants aged 50-75 years (38.6% of women), including 5.6% with high-depressive symptoms and 5.2% on ATD. High depressive symptoms were not associated with low BRS (below the median) even in unadjusted logistic regression analysis (OR = 1.09; 95%CI: 0.91-1.30). Instead, ATD use was related to low BRS in multivariate logistic regression analysis (OR = 1.27; 95% CI: 1.04-1.54). This association remains after adjusting for and matching on propensity score of receiving ATD. A specific association with serotonin and norepinephrine reuptake inhibitors was observed (OR = 1.94; 95% CI: 1.16-3.22).



ATD use and serotonin and norepinephrine reuptake inhibitors in particular, but not high depressive symptoms, is associated with low BRS. If confirmed, these results may bring novel insights into the mechanisms linking depressive symptoms and/or ATD use with cardiovascular disease onset.
INSERM, UMR-S970, Department of Epidemiology, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France. Electronic address: jean-philippe.empana@inserm.fr.
Jean-Philippe
JP
Empana
INSERM, UMR-S970, Department of Epidemiology, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France.
Christof
C
Prugger
Preventive and Clinical Investigation Centre, Paris, France.
Frédérique
F
Thomas
INSERM, UMR-S970, Department of Epidemiology, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France.
Marie-Cécile
MC
Perier
University of Catania, Catania, Italy.
Luca
L
Zanoli
IRCCS Fondazione Don C. Gnocchi, Milan, Italy.
Paolo
P
Castiglioni
INSERM, UMR-S970, Department of Epidemiology, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France.
Catherine
C
Guibout
INSERM, UMR-S970, Department of Epidemiology, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France.
Sophie
S
Causeret
INSERM, UMR-S970, Department of Epidemiology, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France.
Caroline
C
Barnes
Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France; INSERM, U894, Centre Psychiatrie et Neuroscience, Paris, France; APHP, Georges Pompidou European Hospital, Departments of Psychiatry, Paris, France.
Cédric
C
Lemogne
Department of Cardiology, Istituto Auxologico Italiano, Milan, Italy; Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy.
Gianfranco
G
Parati
Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France; INSERM, UMR-S970, Department of Pharmacology of Arterial Wall Mechanics, Paris, France; APHP, Georges Pompidou European Hospital, Department of Pharmacology, Paris, France.
Stéphane
S
Laurent
Preventive and Clinical Investigation Centre, Paris, France.
Bruno
B
Pannier
Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France; INSERM, UMR-S970, Department of Pharmacology of Arterial Wall Mechanics, Paris, France; APHP, Georges Pompidou European Hospital, Department of Pharmacology, Paris, France.
Pierre
P
Boutouyrie
INSERM, UMR-S970, Department of Epidemiology, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France; APHP, Georges Pompidou European Hospital, Department of Cardiology, Paris, France.
Xavier
X
Jouven
D000368:Aged; D000375:Aging; D000928:Antidepressive Agents / Q000494:pharmacology*; D017704:Baroreflex / Q000187:drug effects*; D002318:Cardiovascular Diseases / Q000150:complications / Q000188:drug therapy; D003863:Depression / Q000150:complications / Q000188:drug therapy*; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010297:Paris; D011446:Prospective Studies; D012044:Regression Analysis; D000068760:Serotonin and Noradrenaline Reuptake Inhibitors / Q000494:pharmacology*; D016896:Treatment Outcome
D000928:Antidepressive Agents; D000068760:Serotonin and Noradrenaline Reuptake Inhibitors
Antidepressants; Baroreflex sensitivity; Depressive disorders; Echotracking; Epidemiology