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探索心血管疾病的非常规风险因素:阿片类药物治疗是否被忽视了?

Exploring Unconventional Risk-Factors for Cardiovascular Diseases: Has Opioid Therapy Been Overlooked?

机构信息

Department of Epidemiology and Biostatistics, School of Public Health, Jackson State University, Jackson, MS 39213, USA.

Department of Behavioral and Environmental Health, School of Public Health, Jackson State University, Jackson, MS 39213, USA.

出版信息

Int J Environ Res Public Health. 2019 Jul 18;16(14):2564. doi: 10.3390/ijerph16142564.

Abstract

Approximately 2150 adults die every day in the U.S. from Cardiovascular Diseases (CVD) and another 115 deaths are attributed to opioid-related causes. Studies have found conflicting results on the relationship between opioid therapy and the development of cardiovascular diseases. This study examined whether an association exists between the use of prescription opioid medicines and cardiovascular diseases, using secondary data from the National Hospital Ambulatory Medical Care Survey (NAMCS) 2015 survey. Of the 1829 patients, 1147 (63%) were male, 1762 (98%) above 45 years of age, and 54% were overweight. The rate of cardiovascular diseases was higher among women [( < 0.001), 95% CI: 0.40-0.51]. The covariates were age, race/ethnicity, sex, diabetes mellitus, hyperlipidemia, and hypertension; and were adjusted. Diabetes mellitus, hyperlipidemia, and hypertension were significant predictors of CVD [( < 0.001, 95% CI: 0.57-0.78); ( < 0.001, 95% CI: 0.34-0.44); ( < 0.001, 95% CI: 0.49-0.59)]. There was no significant association between prescription opioid medication use and coronary artery disease [first opioid group = 0.34, Prevalence Odds Ratio (POR): 1.39, 95% CI: 0.71-2.75; second opioid group: = 0.59, POR: 1.20, 95% CI: 0.61-2.37, and third opioid group: = 0.62, POR: 0.85, 95% CI: 0.45-1.6]. The results of this study further accentuate the conflicting results in literature. Further research is recommended, with a focus on those geographical areas where high prevalence of cardiovascular diseases exists.

摘要

美国每天约有 2150 名成年人死于心血管疾病(CVD),另有 115 人死于阿片类药物相关原因。研究发现,阿片类药物治疗与心血管疾病的发展之间存在相互矛盾的结果。本研究使用 2015 年国家医院门诊医疗调查(NAMCS)的二次数据,检查了处方类阿片药物的使用与心血管疾病之间是否存在关联。在 1829 名患者中,1147 名(63%)为男性,1762 名(98%)年龄超过 45 岁,54%超重。女性心血管疾病发病率较高[(<0.001),95%CI:0.40-0.51]。协变量为年龄、种族/民族、性别、糖尿病、高脂血症和高血压;并进行了调整。糖尿病、高脂血症和高血压是 CVD 的显著预测因子[(<0.001,95%CI:0.57-0.78);(<0.001,95%CI:0.34-0.44);(<0.001,95%CI:0.49-0.59)]。处方类阿片药物使用与冠心病之间无显著关联[第一类阿片药物组=0.34,流行率优势比(POR):1.39,95%CI:0.71-2.75;第二类阿片药物组:=0.59,POR:1.20,95%CI:0.61-2.37,第三类阿片药物组:=0.62,POR:0.85,95%CI:0.45-1.6]。本研究结果进一步强调了文献中的矛盾结果。建议进行进一步研究,重点关注心血管疾病高发的那些地理区域。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/17a1/6678387/f87f2cf1b578/ijerph-16-02564-g001.jpg

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