Effects of selective serotonin reuptake inhibitor (SSRI) use on cardiometabolic health and risk in young healthy individuals: A preliminary matched pairs study

Abstract

Selective serotonin reuptake inhibitors (SSRIs) are a class of drugs that are frequently used to treat psychological disorders, but the comprehensive effects on cardiometabolic health in young healthy populations are not well described. Healthy men and women using SSRIs and sex-, age-, height-, and weight-matched controls were assessed. Anthropometrics, blood pressure (BP), arterial stiffness (AS), heart rate variability (HRV), near-infrared vascular occlusion test (NIRS-VOT), and blood lipid profile were assessed, with subsequent Framingham CVD risk score calculation. There were no significant differences in central or peripheral BP or AS due to SSRI use (all, p > 0.39, Cohen's d < 0.48). HRV was not different between groups (all, p > 0.43, Cohen's d < 0.44), except for HFpeak, which was lower in SSRI users (0.20 ± 0.05 vs. 0.28 ± 0.06 Hz, p = 0.04, Cohen's d = 1.26). There were no significant differences in blood lipids (all, p > 0.22, Cohen's d < 0.09) or Framingham risk scores (both, p > 0.68, Cohen's d < 0.14) between groups. There were no significant differences in microvascular reactivity between groups, however, reperfusion slope was lower in SSRI users (1.2 ± 0.9 vs. 2.0 ± 1.1%/s, p = 0.10, Cohen's d = 0.93). SSRIs do not appear to have any significant effects on blood pressure, heart rate variability, arterial stiffness, or lipid profile in young healthy individuals but may influence microvascular function.

Keywords: arterial stiffness; body composition; cardiac autonomic nervous system activity; central blood pressure; mental health; microvascular function.

FIGURE 1

Blood pressure and vascular stiffness measurements in SSRI users (1, n = 7) and matched nonusers (0, n = 7). Central systolic blood pressure (cSBP, Panel a), central diastolic blood pressure (cDBP, Panel b), peripheral systolic blood pressure (pSBP, Panel c), peripheral diastolic blood pressure (pDBP, Panel d), pulse pressure (PP, Panel e), mean arterial pressure (MAP, Panel f), augmentation pressure (AP, Panel g), augmentation index (Aix, Panel h), and augmentation index 75% (Aix75%, Panel i). Data are presented as individual plots and as box and whiskers (median and IQR).

FIGURE 2

Heart rate variability (HRV) in SSRI users (1, n = 7) and matched nonusers (0, n = 7). (a) Heart rate (HR), (b) root mean square of successive differences (RMSSD), (c) natural log RMSSD (LnRMSSD), (d) standard deviation of normal‐to‐normal R‐R intervals (SDNN), (e) R‐R interval (RRInt), (f) percent of successive N‐N (R‐R) intervals >50 ms (pNN50), (g) total power (TotPower), (h) low frequency (LF) and high‐frequency (HF) ratio (LF/HF), (i) LF power, (j) HF power, (k) LF peak, (l) HF peak. Data are presented as individual plots and as box and whiskers (median and IQR). *p < 0.05 SSRI users versus age, sex‐matched controls.

FIGURE 3

Blood lipid panel measures and Framingham CVD Risk scores in SSRI users (1, n = 7) and matched nonusers (0, n = 7). Total cholesterol (Panel a), high‐density lipoprotein (HDL, Panel b), triglycerides (Panel c), low‐density lipoprotein (LDL, Panel d), total cholesterol and high‐density lipoprotein ratio (TC/HDL, Panel e), glucose (Panel f), Framingham CVD risk score (Panel g) and heart age (Panel h). Data are presented as individual plots and as box and whiskers (median and IQR).

FIGURE 4

Muscle oxygen (SmO₂) desaturation and reperfusion slopes from the near‐infrared vascular occlusion test (NIRS‐VOT) in SSRI users (1, n = 7) and matched nonusers (0, n = 7). SmO₂ desaturation (Slope 1, Panel a) and SmO₂ reperfusion (Slope 2, Panel b). Data are presented as individual plots and as box and whiskers (median and IQR).