Association between angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, and major psychiatric disorders

Objective: To exam the association between major psychiatry illness and angiotensin-converting enzyme inhibitor (ACEI) versus angiotensin receptor blocker (ARB) users in a head-to-head comparison manner. Methods: Study design is a retrospective cohort study utilizing available data through the National Health Insurance database. 13,974 ACEI users and 13,974 propensity score matching ARB users were included to look at the future incident psychiatry illness. The Kaplan-Meier method was used to assess the cumulative curves and were tested by the Log-rank test. The crude hazard ratio (HR) and adjusted HR were estimated by univariable and multivariable Cox proportional hazard model. Results: After controlling for the confounders, ACEI users had a higher risk of major psychiatric disorders than ARB users, (adjusted HR = 1.07; 95% CI = 1.02, 1.13). The cumulative incidence of major psychiatric disorders for ACEI cohort was significantly higher than that of ARB cohort (p-value = 0.001). Conclusions: Compared to ARB users, ACEI users are prone to major psychiatry illness development.