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Original Research: PULMONARY VASCULAR DISEASE |

Selective Serotonin Reuptake Inhibitors and Pulmonary Arterial HypertensionAntidepressants and Pulmonary Hypertension: A Case-Control Study

Irfan A. Dhalla, MD; David N. Juurlink, MD, PhD; Tara Gomes, MHSc; John T. Granton, MD; Hong Zheng, MSc; Muhammad M. Mamdani, PharmD, MPH
Author and Funding Information

From the Department of Medicine (Drs Dhalla, Juurlink, and Granton), the Department of Health Policy, Management, and Evaluation (Drs Dhalla, Juurlink, and Mamdani), and the Leslie Dan Faculty of Pharmacy (Ms Gomes and Dr Mamdani), University of Toronto; the Department of Medicine (Dr Dhalla), and the Li Ka Shing Knowledge Institute (Dr Dhalla and Dr Mamdani), St. Michael’s Hospital; the Institute for Clinical Evaluative Sciences (Drs Dhalla, Juurlink, and Mamdani; Mss Gomes and Zheng); the Sunnybrook Research Institute (Dr Juurlink); and the Division of Respirology (Dr Granton), University Health Network, Toronto, ON, Canada.

Correspondence to: Irfan A. Dhalla, MD, Department of Medicine, St. Michael’s Hospital, 30 Bond St, Toronto, ON, M5B 1W8, Canada; e-mail: dhallai@smh.ca


Funding/Support: This study was funded by a grant from the Ontario Ministry of Health and Long-Term Care to the Ontario Drug Policy Research Network, which is led by Muhammad Mamdani and David Juurlink. This study was supported by the Institute for Clinical Evaluative Sciences (ICES), which is funded by an annual grant from the Ontario Ministry of Health and Long-Term Care (MOHLTC).

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestpubs.org/site/misc/reprints.xhtml).


© 2012 American College of Chest Physicians


Chest. 2012;141(2):348-353. doi:10.1378/chest.11-0426
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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.

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