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Updated: Jun 18, 2025
Author Spotlight: Exploring the Relationship Between Lipotoxicity and HFpEF
Published on: March 29, 2024
Association between prescription opioid use and heart failure: Cohort studies and Mendelian randomization analysis
Guang Hao1, Xia Chen2, Zhenger Fang2
1School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China.
Insights
Prescription opioid use (POU) significantly increases heart failure (HF) risk by 32%. This study confirms a causal link between POU and HF, highlighting the need for careful monitoring in at-risk populations.
Area of Science:
- Cardiology
- Pharmacology
- Genetics
Background:
- Prescription opioid use (POU) is linked to cardiovascular disease (CVD).
- The association between POU and heart failure (HF) remains understudied.
- This research investigates the potential causal relationship between POU and HF.
Purpose of the Study:
- To examine the longitudinal association between POU and HF.
- To assess the potential causal association between POU and HF using Mendelian Randomization (MR).
Main Methods:
- Utilized cohort data from the Health and Retirement Study (HRS) and UK Biobank.
- Employed two-sample MR analysis with genome-wide association study (GWAS) summary statistics.
- Performed sensitivity analyses to check for pleiotropy and heterogeneity.
Main Results:
- Observational analysis showed a 32% increased HF risk in POU users (HR=1.32).
- MR analysis suggested a causal effect of genetic liability for POU on increased HF risk (OR=1.16).
- Sensitivity analyses indicated consistent results, with no significant pleiotropy or heterogeneity.
Conclusions:
- POU is associated with a significantly high risk of developing HF.
- Findings provide novel insights into the impact of POU on heart failure.
- Further research is warranted to validate these findings and explore underlying mechanisms.
Background:
Prescription opioid use (POU) has been shown to lead to cardiovascular disease (CVD), but its association with heart failure has not been well studied. We investigated the potential causal association between POU and HF using cohort studies and Mendelian Randomization (MR) analysis.
Methods:
Initially, we examined the longitudinal association between POU and HF using the data from the Health and Retirement Study (HRS) and the UK biobank. Next, we employed a two-sample MR analysis using summary statistics from genome-wide association studies (GWAS) to assess the potential causal associations between POU and HF.
Results:
During a median of 3.8 and 13.8 years of follow-up, there were 441(8.04 per 1000 person-year) and 16,170 (3.96 per 1000 person-year) HF cases in the HRS and the UK biobank, respectively. After adjusting for covariates, participants who used prescription opioids had a 32% increased risk of developing HF, compared with non-users (HR = 1.32, 95%CI: 1.26-1.38, P < 0.001). In the MR analysis, summary statistics for POU were obtained from 78,808 UK Biobank study participants, and summary data for HF were obtained from 218,792 participants of a European population. A causal effect of genetic liability for POU on an increased risk of HF (OR = 1.16, 95% CI = 1.06, 1.27, P = 0.001) was suggested. The results were generally consistent in the sensitivity analysis, and no pleiotropy or heterogeneity were observed.
Conclusions:
POU is associated with a high risk of HF. Our findings provide new insight into prescription opioid use among populations at risk of heart failure. More studies are needed to validate our results and further investigate the underlying mechanisms.
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