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...
| Main Authors: | , , , , , , , , |
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| Format: | Journal Article |
| Language: | English |
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WILEY PERIODICALS, INC
2022
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| Subjects: | |
| Online Access: | http://purl.org/au-research/grants/nhmrc/334047 http://hdl.handle.net/20.500.11937/93088 |
| _version_ | 1848765694062100480 |
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| author | Liew, S.M. Chowdhury, Enayet Ernst, M.E. Gilmartin-Thomas, J. Reid, Christopher Tonkin, A. Neumann, J. McNeil, J.J. Kaye, D.M. |
| author_facet | Liew, S.M. Chowdhury, Enayet Ernst, M.E. Gilmartin-Thomas, J. Reid, Christopher Tonkin, A. Neumann, J. McNeil, J.J. Kaye, D.M. |
| author_sort | Liew, S.M. |
| building | Curtin Institutional Repository |
| collection | Online Access |
| description | 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. |
| first_indexed | 2025-11-14T11:39:19Z |
| format | Journal Article |
| id | curtin-20.500.11937-93088 |
| institution | Curtin University Malaysia |
| institution_category | Local University |
| language | English |
| last_indexed | 2025-11-14T11:39:19Z |
| publishDate | 2022 |
| publisher | WILEY PERIODICALS, INC |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | curtin-20.500.11937-930882023-09-18T04:52:35Z Prescribed opioid use is associated with adverse cardiovascular outcomes in community-dwelling older persons Liew, S.M. Chowdhury, Enayet Ernst, M.E. Gilmartin-Thomas, J. Reid, Christopher Tonkin, A. Neumann, J. McNeil, J.J. Kaye, D.M. Science & Technology Life Sciences & Biomedicine Cardiac & Cardiovascular Systems Cardiovascular System & Cardiology Opioids Cardiovascular disease Epidemic Heart failure NONSTEROIDAL ANTIINFLAMMATORY DRUGS SUDDEN CARDIAC DEATH SLEEP-APNEA CHRONIC PAIN MYOCARDIAL-INFARCTION OXIDATIVE STRESS REDUCING EVENTS RISK CYCLOOXYGENASE DISEASE Cardiovascular disease Epidemic Heart failure Opioids Humans Female Aged Aged, 80 and over Male Independent Living Opioid-Related Disorders Analgesics, Opioid Drug Overdose Cardiovascular Diseases Humans Cardiovascular Diseases Opioid-Related Disorders Analgesics, Opioid Aged Aged, 80 and over Female Male Independent Living Drug Overdose 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. 2022 Journal Article http://hdl.handle.net/20.500.11937/93088 10.1002/ehf2.14101 English http://purl.org/au-research/grants/nhmrc/334047 http://purl.org/au-research/grants/nhmrc/1127060 http://purl.org/au-research/grants/nhmrc/1136372 http://purl.org/au-research/grants/nhmrc/1173690 http://purl.org/au-research/grants/nhmrc/1136080 http://creativecommons.org/licenses/by-nc/4.0/ WILEY PERIODICALS, INC fulltext |
| spellingShingle | Science & Technology Life Sciences & Biomedicine Cardiac & Cardiovascular Systems Cardiovascular System & Cardiology Opioids Cardiovascular disease Epidemic Heart failure NONSTEROIDAL ANTIINFLAMMATORY DRUGS SUDDEN CARDIAC DEATH SLEEP-APNEA CHRONIC PAIN MYOCARDIAL-INFARCTION OXIDATIVE STRESS REDUCING EVENTS RISK CYCLOOXYGENASE DISEASE Cardiovascular disease Epidemic Heart failure Opioids Humans Female Aged Aged, 80 and over Male Independent Living Opioid-Related Disorders Analgesics, Opioid Drug Overdose Cardiovascular Diseases Humans Cardiovascular Diseases Opioid-Related Disorders Analgesics, Opioid Aged Aged, 80 and over Female Male Independent Living Drug Overdose Liew, S.M. Chowdhury, Enayet Ernst, M.E. Gilmartin-Thomas, J. Reid, Christopher Tonkin, A. Neumann, J. McNeil, J.J. Kaye, D.M. Prescribed opioid use is associated with adverse cardiovascular outcomes in community-dwelling older persons |
| title | Prescribed opioid use is associated with adverse cardiovascular outcomes in community-dwelling older persons |
| title_full | Prescribed opioid use is associated with adverse cardiovascular outcomes in community-dwelling older persons |
| title_fullStr | Prescribed opioid use is associated with adverse cardiovascular outcomes in community-dwelling older persons |
| title_full_unstemmed | Prescribed opioid use is associated with adverse cardiovascular outcomes in community-dwelling older persons |
| title_short | Prescribed opioid use is associated with adverse cardiovascular outcomes in community-dwelling older persons |
| title_sort | prescribed opioid use is associated with adverse cardiovascular outcomes in community-dwelling older persons |
| topic | Science & Technology Life Sciences & Biomedicine Cardiac & Cardiovascular Systems Cardiovascular System & Cardiology Opioids Cardiovascular disease Epidemic Heart failure NONSTEROIDAL ANTIINFLAMMATORY DRUGS SUDDEN CARDIAC DEATH SLEEP-APNEA CHRONIC PAIN MYOCARDIAL-INFARCTION OXIDATIVE STRESS REDUCING EVENTS RISK CYCLOOXYGENASE DISEASE Cardiovascular disease Epidemic Heart failure Opioids Humans Female Aged Aged, 80 and over Male Independent Living Opioid-Related Disorders Analgesics, Opioid Drug Overdose Cardiovascular Diseases Humans Cardiovascular Diseases Opioid-Related Disorders Analgesics, Opioid Aged Aged, 80 and over Female Male Independent Living Drug Overdose |
| url | http://purl.org/au-research/grants/nhmrc/334047 http://purl.org/au-research/grants/nhmrc/334047 http://purl.org/au-research/grants/nhmrc/334047 http://purl.org/au-research/grants/nhmrc/334047 http://purl.org/au-research/grants/nhmrc/334047 http://hdl.handle.net/20.500.11937/93088 |