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Blockade of the angiotensin system improves mental health domain of quality of life: a meta-analysis of randomized clinical trials

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dc.contributor.authorBrownstein, Daniel J.
dc.contributor.authorSalagre, Estela
dc.contributor.authorKöhler, Cristiano
dc.contributor.authorStubbs, Brendon
dc.contributor.authorVian, João
dc.contributor.authorPereira, Ciria
dc.contributor.authorChavarria, Victor
dc.contributor.authorKarmakar, Chandan
dc.contributor.authorTurner, Alyna
dc.contributor.authorQuevedo, João
dc.contributor.authorCarvalho, André F.
dc.contributor.authorBerk, Michael
dc.contributor.authorFernandes, Brisa S.
dc.date.accessioned2022-02-28T16:49:14Z
dc.date.available2022-02-28T16:49:14Z
dc.date.issued2017
dc.description© The Royal Australian and New Zealand College of Psychiatrists 2017pt_PT
dc.description.abstractObjective: It is unclear whether blockade of the angiotensin system has effects on mental health. Our objective was to determine the impact of angiotensin converting enzyme inhibitors and angiotensin II type 1 receptor (AT1R) blockers on mental health domain of quality of life. Study design: Meta-analysis of published literature. Data sources: PubMed and clinicaltrials.gov databases. The last search was conducted in January 2017. Study selection: Randomized controlled trials comparing any angiotensin converting enzyme inhibitor or AT1R blocker versus placebo or non-angiotensin converting enzyme inhibitor or non-AT1R blocker were selected. Study participants were adults without any major physical symptoms. We adhered to meta-analysis reporting methods as per PRISMA and the Cochrane Collaboration. Data synthesis: Eleven studies were included in the analysis. When compared with placebo or other antihypertensive medications, AT1R blockers and angiotensin converting enzyme inhibitors were associated with improved overall quality of life (standard mean difference = 0.11, 95% confidence interval = [0.08, 0.14], p < 0.0001), positive wellbeing (standard mean difference = 0.11, 95% confidence interval = [0.05, 0.17], p < 0.0001), mental (standard mean difference = 0.15, 95% confidence interval = [0.06, 0.25], p < 0.0001), and anxiety (standard mean difference = 0.08, 95% confidence interval = [0.01, 0.16], p < 0.0001) domains of QoL. No significant difference was found for the depression domain (standard mean difference = 0.05, 95% confidence interval = [0.02, 0.12], p = 0.15). Conclusions: Use of angiotensin blockers and inhibitors for the treatment of hypertension in otherwise healthy adults is associated with improved mental health domains of quality of life. Mental health quality of life was a secondary outcome in the included studies. Research specifically designed to analyse the usefulness of drugs that block the angiotensin system is necessary to properly evaluate this novel psychiatric target.pt_PT
dc.description.sponsorshipB.S.F. is supported by a postdoctoral fellowship from Deakin University, Australia. C.A.K. is supported by a postdoctoral scholarship from the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES; Brazil). A.F.C. is supported by a research fellowship award from the Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq; Brazil). J.Q. is a 1A CNPq Research Fellow. M.B. is supported by a NHMRC Senior Principal Research Fellowship 1059660.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationAust N Z J Psychiatry. 2018 Jan;52(1):24-38pt_PT
dc.identifier.doi10.1177/0004867417721654pt_PT
dc.identifier.eissn1440-1614
dc.identifier.issn0004-8674
dc.identifier.urihttp://hdl.handle.net/10451/51559
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherSagept_PT
dc.relation.publisherversionhttps://journals.sagepub.com/home/anppt_PT
dc.subjectPrecision psychiatrypt_PT
dc.subjectAngiotensin systempt_PT
dc.subjectMental healthpt_PT
dc.subjectMeta-analysispt_PT
dc.subjectPersonalized medicinept_PT
dc.subjectQuality of lifept_PT
dc.titleBlockade of the angiotensin system improves mental health domain of quality of life: a meta-analysis of randomized clinical trialspt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage38pt_PT
oaire.citation.issue1pt_PT
oaire.citation.startPage24pt_PT
oaire.citation.titleAustralian & New Zealand Journal of Psychiatrypt_PT
oaire.citation.volume52pt_PT
person.familyNameVian
person.givenNameJoão
person.identifier.orcid0000-0001-5260-2335
rcaap.rightsrestrictedAccesspt_PT
rcaap.typearticlept_PT
relation.isAuthorOfPublicationaf38a5c9-dfd0-45a2-912b-b0e94a0af9e9
relation.isAuthorOfPublication.latestForDiscoveryaf38a5c9-dfd0-45a2-912b-b0e94a0af9e9

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