Association between Antidepressant Medication Use and Prevalence and Control of Cardiovascular Risk Factors in Community-Dwelling Older Adults: The Italian Health Examination Survey 2008-2012

Background: To assess the association of antidepressant (AD) medication use with prevalence and control of cardiovascular (CV) risk factors. Methods: Data of older adults from the population-based Italian Osservatorio Epidemiologico Cardiovascolare/Health Examination Survey (OEC/HES) Study 2008-2012 were used. CV risk factors were measured using standardized procedures. Information on clinical features, lifestyles, and medications was collected using standardized questionnaires. Logistic regression models were elaborated to assess associations between AD use and prevalence and control of CV risk factors. Results: Around 2549 participants (age 71.4 ± 4.2 years, 51.3% men) were studied; 268 (10.5%) were AD users. Of these, 72.4% used selective serotonin reuptake inhibitors (SSRI). AD users had less favorable CV risk factor profile and were less likely to achieve control of blood pressure and total cholesterol. After multiple adjustment for potentially confounding variables, AD use was associated with greater likelihood of having diabetes (OR=1.05, 95% CI=1.02-1.10, P=0.008), hypertension (OR=1.10, 95% CI=1.05-1.20, P=0.003), and hypercholesterolemia (OR=1.08, 95% CI=1.04-1.14, P < 0.001). Among participants treated for hypertension and hypercholesterolemia, AD use was associated with poorer control of BP (OR=1.07, 95% CI=1.03-1.12, P=0.001) and cholesterol (OR=1.06, 95% CI=1.01-1.12, P=0.021). Results persisted virtually unchanged when analyses were restricted to participants on SSRI. Conclusions: AD use was associated with greater prevalence and poorer control of traditional risk factors for CV disease in a population-based sample of older adults. Such results highlight the need for surveillance of CV risk factors and promotion of healthy lifestyles in older adults with psychopathology and, in particular, in those under AD treatment