Selective serotonin reuptake inhibitors and pulmonary arterial hypertension: a case-control study

Irfan A Dhalla; David N Juurlink; Tara Gomes; John T Granton; Hong Zheng; Muhammad M Mamdani

doi:10.1378/chest.11-0426

Selective serotonin reuptake inhibitors and pulmonary arterial hypertension: a case-control study

Chest. 2012 Feb;141(2):348-353. doi: 10.1378/chest.11-0426. Epub 2011 Aug 18.

Authors

Irfan A Dhalla¹, David N Juurlink², Tara Gomes³, John T Granton⁴, Hong Zheng⁵, Muhammad M Mamdani⁶

Affiliations

¹ Department of Medicine, Toronto, ON, Canada; Department of Health Policy, Management, and Evaluation, Toronto, ON, Canada; Department of Medicine, Toronto, ON, Canada; Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada; Institute for Clinical Evaluative Sciences, Toronto, ON, Canada. Electronic address: dhallai@smh.ca.
² Department of Medicine, Toronto, ON, Canada; Department of Health Policy, Management, and Evaluation, Toronto, ON, Canada; Institute for Clinical Evaluative Sciences, Toronto, ON, Canada; Sunnybrook Research Institute, Toronto, ON, Canada.
³ Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada; Institute for Clinical Evaluative Sciences, Toronto, ON, Canada.
⁴ Department of Medicine, Toronto, ON, Canada; Division of Respirology, University Health Network, Toronto, ON, Canada.
⁵ Institute for Clinical Evaluative Sciences, Toronto, ON, Canada.
⁶ Department of Health Policy, Management, and Evaluation, Toronto, ON, Canada; Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada; Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada; Institute for Clinical Evaluative Sciences, Toronto, ON, Canada.

PMID: 21852294
DOI: 10.1378/chest.11-0426

Abstract

Background: Animal and human studies suggest that selective serotonin reuptake inhibitors (SSRIs) might be useful for the prevention or treatment of pulmonary arterial hypertension.

Methods: We conducted a population-based, nested case-control study to explore the hypothesis that SSRIs might reduce the risk of pulmonary arterial hypertension. Cases were individuals who developed pulmonary arterial hypertension requiring pharmacologic treatment. For each case, we selected up to 10 matched control subjects. Exposure to SSRIs and non-SSRI antidepressants was ascertained using administrative data. The outcome of pulmonary arterial hypertension requiring pharmacologic therapy was defined as the receipt of a drug specific for the treatment of pulmonary arterial hypertension.

Results: In contrast to our hypothesis, and likely because of residual confounding, we found a positive association between SSRI use and pulmonary arterial hypertension (adjusted OR, 1.55; 95% CI, 1.13-2.13).

Conclusions: At conventional doses, SSRIs are not associated with a reduced risk of pulmonary arterial hypertension.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Case-Control Studies
Female
Humans
Hypertension, Pulmonary / drug therapy*
Logistic Models
Male
Ontario
Selective Serotonin Reuptake Inhibitors / administration & dosage
Selective Serotonin Reuptake Inhibitors / therapeutic use*
Treatment Outcome

Substances

Serotonin Uptake Inhibitors