β-Blockers are important drugs in the treatment of cardiovascular diseases. They are suspected of inducing various psychiatric adverse events (PAEs), particularly depression, affecting cardiovascular morbidity and mortality. We performed a systematic search for double-blind, randomized controlled trials investigating β-blockers to analyze the risk of PAEs or withdrawal of therapy due to PAEs. We extracted the frequencies of PAEs and rates of withdrawals and reviewed them to the number of exposed patients. For β-blockers versus placebo or other active treatment, we calculated odds ratios for individual PAEs and withdrawal rates. We retrieved overall 285 eligible studies encompassing 53 533 patients. The risk of bias was judged to be high in 79% of the studies. Despite being the most frequently reported PAE with a total of 1600 cases, depression did not occur more commonly during β-blockers than during placebo (odds ratio, 1.02 [95% CI, 0.83–1.25]). β-Blocker use was also not associated with withdrawal for depression (odds ratio, 0.97 [95% CI, 0.51–1.84]). Similar results were obtained for comparisons against active agents. Among other PAEs, only unusual dreams, insomnia, and sleep disorder were possibly related to β-blocker therapy. In conclusion, this analysis of large-scale data from double-blind, randomized controlled trials does not support an association between β-blocker therapy and depression. Similarly, no effect for β-blockers was found for other PAEs, with the possible exceptions of sleep-related disorders. Consequently, concerns about β-blockers’ impact on psychological health should not affect their use in clinical practice.

In genome-wide association studies, genetic variants in the UMOD gene associate with kidney function, blood pressure (BP), and hypertension. Elevated BP is linked to kidney function and impaired cognitive as well as physical performance in later life. We investigated the association between UMOD rs4293393–A > G and kidney function, BP, cognitive and physical function in the Berlin Aging Study II (BASE–II). Data of 1556 older BASE–II participants (mean age 68.2 ± 3.7 years) were analyzed. BP was determined by standardized automated measurements, estimated glomerular filtration rate (eGFR) by CKD Epidemiology Collaboration creatinine equation. Cognitive function was assessed by Mini-Mental State Examination and Digit Symbol Substitution Test, while physical function by Handgrip Strength and Timed Up and Go-Test. Association analyses were performed by covariance and logistic regression models adjusting for sex. G–allele carriers at UMOD rs4293393 exhibited significantly higher eGFR values compared to non–carriers (AA, 76.4 ml/min/1.73 m², CI: 75.7–77.2 vs. AG, 78.4 ml/min/1.73 m², CI: 77.3–79.5 vs. GG, 78.5 ml/min/1.73 m², CI: 75.4–81.7; P = 0.010), and a lower risk of eGFR < 60 mL/min/1.73 m2 (AG, OR: 0.63, CI: 0.41–0.97, P = 0.033). However, UMOD rs4293393 genotypes were not associated with BP, diagnosis of hypertension or cognitive and physical function parameters. Our data corroborate previous findings on the association of UMOD rs4293393-G with better kidney function in older adults. However, no association between UMOD and BP or physical and cognitive parameters in these community-dwelling older adults was detected.

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Genetic variants in UMOD associate with kidney function and hypertension. These phenotypes are also linked to sex-related differences and impairment in cognitive and physical function in older age. Here we evaluate longitudinal associations between a common UMOD rs4293393-A>G variant and changes in estimated glomerular filtration rate (eGFR), blood pressure (BP), cognitive and physical function parameters in older participants in the BASE-II after long-term follow-up as part of the GendAge study. Overall, 1010 older participants (mean age 75.7 ± 3.7 years, 51.6% women) were analyzed after follow-up (mean 7.4 years) both in cross-sectional analysis and in longitudinal analysis as compared to baseline. In cross-sectional analysis, heterozygous G–allele carriers exhibited significantly higher eGFR values (AA, 71.3 ml/min/1.73 m2, 95% CI, 70.3–72.3 vs. AG, 73.5 ml/min/1.73 m2, 95% CI, 72.1–74.9, P = 0.033). Male heterozygous G-allele carriers had lower odds of eGFR < 60 mL/min/1.73 m2 (OR 0.51, 95% CI, 0.28–0.95, P = 0.032) and in Timed Up and Go-Test ≥ 10 s (OR 0.50, 95% CI, 0.29–0.85, P = 0.011) whereas women were less likely to have hypertension (OR 0.58, CI, 0.37–0.91, P = 0.018). UMOD genotypes were not significantly associated with longitudinal changes in any investigated phenotype. Thus, while the impact of UMOD rs4293393 on kidney function is maintained in aging individuals, this variant has overall no impact on longitudinal changes in BP, kidney, cognitive or functional phenotypes. However, our results suggest a possible sex-specific modifying effect of UMOD on eGFR and physical function in men and hypertension prevalence in women.

Objective: Central hemodynamic indices have been established as parameters of arterial health, but the prognostic value of central vs. conventional office blood pressure (OBP) measurements remains unclear. Furthermore, the use of attended vs. unattended automated OBP measurements is a current topic of controversy. Design and method: We conducted a prospective cohort study in general practice in Germany and included 42 consecutive patients with hypertension. The Mobil-O-Graph oscillometric device was used for the automated OBP recordings in all patients. Measurements were performed in a separate quiet room after five minutes rest in seated position. We compared in random order in each patient the attended vs. unattended automated central and peripheral systolic OBP (SOBP), diastolic OBP (DOBP), and pulse velocity wave (PVW). Results: The mean age of patients was 71 years (range 34–89 years, 54.8% females). Patients were treated on average with 1.95 antihypertensive drugs. The mean attended and unattended automated peripheral SOBP (131.7 and 131.6 mmHg, respectively) and DOBP (83.4 and 82.4 mmHg, respectively) values recorded by the device were not significantly different. In addition, there was no difference between the mean attended and unattended central aortic SOBP (120.1 and 120.2 mmHg, respectively) and DOBP (84.7 and 83.7 mmHg, respectively) values. Bland-Altman analysis revealed the small inter-individual differences between attended und unattended peripheral and central SOBP and DOBP values. There was no asymmetry and narrow limits of agreement between the two methods. Finally, no significant difference for PVW was found between attended and unattended measurements (10.1 and 10.2 m/sec, respectively). Conclusions: The attended versus unattended status of automated OBP measurements had no impact on derived peripheral OBP, central OBP and PVW values in general practice when using the Mobil-O-Graph oscillometric device.

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Objective: Beta-blockers (BB) are among the most frequently prescribed medications worldwide. In the past, their potential to induce depression has been discussed controversially, and heterogeneous results have been published. We hypothesized that possible reasons for this heterogeneity may be differences in (1) the classification of patient-reported symptoms as “depression”, (2) the ability to pass the blood-brain-barrier for different BB, and (3) cerebral vulnerability of the exposed patients. In our study, we investigate the influence of BB use on two different cardinal symptoms of depression, depressive mood and asthenia. Furthermore, we examine whether the magnitude of these symptoms is moderated by the lipophilia of the BB and by the presence of dementia in Alzheimer's disease (DAT) as an indicator of cerebral damage. Design and Method: In this retrospective monocentric study we evaluated 196 patients aged 55 to 89 years who were admitted in our outpatient clinic for cognitive disorders. The sample included 98 users of BB, of whom 60 were diagnosed with DAT and 38 had subjective cognitive impairment (SCI) but inconspicuous results in neuropsychological testing and cerebral imaging. Furthermore, 13 patients had comorbid depression. A set of 98 non-users of BB was randomly matched to the BB users based on demographic parameters (gender, age, educational level) and psychiatric diagnoses. Depressive mood and asthenia were measured using subscores of the Geriatric Depression Scale (GDS). Design and method: We found a significant association between BB use and the GDS subscores for both asthenia and depressive mood, with higher values in BB users than in non-users (2.83 vs. 1.96; p < 0.01 and 2.39 vs. 1.62; p < 0.05). The risk was not affected by lipophilia status of BB (high vs. moderate) or cognitive diagnosis (DAT vs. SCI). Conclusion: The magnitude of both asthenia and depressive mood was distinctly higher in users of BB. Neither lipophilia of BB nor presence of DAT substantially influenced symptoms. In patients presenting with cognitive disorders on a BB medication, BB should be critically evaluated as possible etiology of asthenia and depressive mood.