Is hypertension associated with sertraline (Selective Serotonin Reuptake Inhibitor)?

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Dainyal Siddiqui, MD

Internal Medicine

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Manuel Jimenez, MD

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Franz Pierre-Louis, MD

Infectious Disease

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Last updated: February 28, 2025 • View editorial policy

From the Guidelines

Sertraline is not directly associated with causing hypertension, but it can have a neutral effect on weight, which may indirectly influence blood pressure. When considering the relationship between sertraline and hypertension, it's essential to examine the effects of selective serotonin reuptake inhibitors (SSRIs) on weight, as changes in weight can impact blood pressure. According to the study 1, SSRIs like sertraline have been associated with weight loss in the short term and weight neutrality in the long term. This suggests that sertraline may not have a significant direct impact on hypertension. However, it's crucial to monitor blood pressure in patients taking sertraline, especially if they have a history of hypertension or are at risk of developing it.

Some key points to consider:

  • Sertraline's effect on weight is generally neutral, especially with long-term use 1.
  • Weight-neutral antihypertensive medications, such as angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, and calcium channel blockers, may be preferable for patients with weight concerns 1.
  • Lifestyle modifications, including reducing sodium intake, regular exercise, limiting alcohol, and stress management techniques, can help manage blood pressure while on sertraline.
  • If hypertension persists or worsens, antihypertensive medication may be prescribed alongside sertraline, with careful monitoring for potential drug interactions.

In terms of managing hypertension in patients taking sertraline, it is recommended to prioritize lifestyle modifications and monitor blood pressure regularly. If antihypertensive medication is necessary, weight-neutral options should be considered to minimize potential interactions with sertraline. Overall, while sertraline may not directly cause hypertension, its indirect effects on weight and potential interactions with antihypertensive medications must be carefully managed to prioritize patient health and well-being.

From the Research

Association between Hypertension and Sertraline

  • Hypertension is a significant health issue affecting millions of adults worldwide, and it is a leading cause of cardiovascular disease morbidity and mortality 2.
  • The use of selective serotonin reuptake inhibitors (SSRIs), such as sertraline, has been investigated in relation to hypertension.
  • A study published in 2018 found that sertraline effectively removed or reduced symptoms of paroxysmal hypertension in the majority of patients who used this treatment, with a significant decrease in mean office blood pressure 3.
  • Another study published in 2019 analyzed reports of hypertension associated with SSRIs, including sertraline, in two pharmacovigilance databases, and found a significant pharmacovigilance safety signal between the use of SSRIs and the development or worsening of hypertension 4.
  • An observational study published in 2020 found that sertraline was effective in the management of newly diagnosed depression among patients with type 2 diabetes mellitus or hypertension, but did not find a statistically significant difference in blood pressure values between baseline and 12th week of comparison 5.
  • A case report analysis published in 2019 discussed the management of severe arterial hypertension associated with serotonin syndrome, and suggested that classic antihypertensives may not be effective, while benzodiazepines, cyproheptadine, or propofol may be beneficial in controlling blood pressure 6.

Key Findings

  • Sertraline may be associated with a reduction in symptoms of paroxysmal hypertension and a decrease in blood pressure 3.
  • The use of SSRIs, including sertraline, may be linked to an increased risk of hypertension or worsening of existing hypertension 4.
  • Sertraline may be effective in managing depression in patients with hypertension, but its effect on blood pressure is unclear 5.

References

1
Guideline

practical use of pharmacotherapy for obesity.

Gastroenterology, 2017

3
Research

Effect of sertraline in paroxysmal hypertension.

Biomedical papers of the Medical Faculty of the University Palacky, Olomouc, Czechoslovakia, 2018

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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