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

Abstract

Animal and human studies suggest that selective serotonin reuptake inhibitors (SSRIs) might be useful for the prevention or treatment of pulmonary arterial hypertension. 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. 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). At conventional doses, SSRIs are not associated with a reduced risk of pulmonary arterial hypertension.