Angiotensin Receptor Blockers and risk of suicide

This is a well-conducted study from Canada, published in JAMA Network Open in October 2019 [1].

In this case-control study of 964 older adults who died by suicide and 3856 matched control participants, compared with angiotensin converting enzyme inhibitors (ACEi), exposure to angiotensin receptor blockers (ARBs) was associated with a higher risk of suicide. Findings were consistent in a sensitivity analysis that excluded individuals with a history of self-harm.  ARBs may be associated with a higher risk of suicide than ACEi.

Preferential use of ACEIs over ARBs should be considered whenever possible, particularly in patients with severe mental health illness.

1            Mamdani M, Gomes T, Greaves S, et al. Association Between Angiotensin-Converting Enzyme Inhibitors, Angiotensin Receptor Blockers, and Suicide. JAMA Netw Open 2019;2:e1913304. doi:10.1001/jamanetworkopen.2019.13304