US Pharm. 2019;44(3):33-35.

According to research presented in Chicago at the American Heart Association’s Scientific Sessions 2018, a premier global exchange of the latest advances in cardiovascular science for researchers and clinicians, opioid use appears to increase a person’s risk for developing atrial fibrillation, a dangerous heart-rhythm disorder known to cause strokes.

The results, based on analysis of medical records of more than 850,000 young and middle-aged military veterans, show opioid use increases the likelihood of atrial fibrillation by 34%.

Atrial fibrillation is the most common heart-rhythm disorder, characterized by the chaotic quivering of the heart’s upper chambers, and is one of the leading causes of strokes. There is mounting evidence that opioids can cause cardiovascular damage, yet the mechanisms by which these medications promote heart disease remain poorly understood.

The new findings suggest that one way in which opioids could drive cardiovascular damage may be through heart-rhythm abnormalities, such as atrial fibrillation. “We all know that the opioid epidemic is taking an unspeakable human toll through addiction, abuse, and overdose, but our findings suggest that the toll may be even greater when we consider the cardiovascular effects opioids may have,” said lead investigator Jonathan Stock, MD, a resident at Yale New Haven Hospital in Connecticut.

The team said their findings—based on tracking opioid use rather than abuse—underscore the notion that opioid use, by itself, is dangerous even in the absence of abuse or full-blown addiction.

“Our results point to the importance of prescribing opioids only as a last resort,” Stock said. “Opioid use, by itself, must be taken seriously, and efforts should be made not only to reduce opioid abuse and overdoses but to ensure patients are being prescribed opioids only when absolutely necessary.”