Prescribed opioid use is associated with adverse cardiovascular outcomes in community-dwelling older persons

Aims: Prescribed opioids are commonly used in the older community-dwelling population for the treatment of chronic pain. Although the harmful effects of opioid abuse and overdose are well understood, little is known about the long-term cardiovascular (CV) effects of prescribed opioids. The aim of th...

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Bibliographic Details
Main Authors: Liew, S.M., Chowdhury, Enayet, Ernst, M.E., Gilmartin-Thomas, J., Reid, Christopher, Tonkin, A., Neumann, J., McNeil, J.J., Kaye, D.M.
Format: Journal Article
Language:English
Published: WILEY PERIODICALS, INC 2022
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Online Access:http://purl.org/au-research/grants/nhmrc/334047
http://hdl.handle.net/20.500.11937/93088
Description
Summary:Aims: Prescribed opioids are commonly used in the older community-dwelling population for the treatment of chronic pain. Although the harmful effects of opioid abuse and overdose are well understood, little is known about the long-term cardiovascular (CV) effects of prescribed opioids. The aim of this study was to investigate the CV effects associated with prescribed opioid use. Methods and results: A post hoc analysis of participants in the Aspirin in Reducing Events in the Elderly (ASPREE) trial was conducted. Participants in the ASPREE trial included community-dwelling older adults without a prior history of CV disease (CVD). Prescribed opioid use was defined as opioid use at baseline and/or at the first annual visit (AV1). Cox proportional hazards regression was used to calculate hazard ratios and 95% confidence intervals (95% CI) for associations between opioid use and CVD events following AV1. Of the 17 701 participants included (mean age 75.2 years, 58.2% female), 813 took opioids either at baseline or at AV1. Over a median follow-up period of 3.58 years (IQR 2.50–4.62), CVD events, most notably heart failure hospitalization, occurred in 7% (n = 57) amongst opioid users and 4% (n = 680) amongst non-opioid users. After adjustment for multiple covariates, opiate use was associated with a 1.67-fold (CI 1.26–2.23, P < 0.001) increase in the hazard ratio for CVD events. Conclusions: These findings identify opioid use as a non-traditional risk factor for CVD events in community-dwelling older adults.