Table 2.
Association of baseline prescription opioid use (POU) with acute coronary heart disease (CHD), stroke, and cardiovascular disease (CVD) death among REGARDS participants
| Acute CHD | ||||||
|---|---|---|---|---|---|---|
| All N = 29,025 | No baseline CHD N = 23,969 | Baseline CHD N = 5,056 | ||||
| POU | Nonusers | POU | Nonusers | POU | Nonusers | |
| Participants, n | 1,851 | 27,174 | 1,438 | 22,531 | 413 | 4,643 |
| Events, n | 105 | 1257 | 56 | 712 | 49 | 545 |
| IR (95%CI)‡ | 11.7 (10.6–15.0)∗∗ | 8.3 (7.8–8.8) | 8.0 (6.1–10.4)∗ | 5.7 (5.2–6.2) | 28.7 (21.7–38.0) | 24.0 (22.0–26.2) |
| HR (95%CI) † | HR (95%CI) | HR (95%CI) | ||||
| Model 1 | 1.41 (1.15–1.72) | 1.39 (1.06–1.82) | 1.19 (0.89–1.60) | |||
| Model 2¶ | 1.17 (0.96–1.44) | 1.28 (0.97–1.68) | 1.14 (0.85–1.53) | |||
| Model 3¶ | 1.03 (0.83–1.26) | 1.08 (0.81–1.43) | 0.96 (0.70–1.30) | |||
| Model 4¶ | 1.03 (0.83–1.26) | 1.06 (0.80–1.41) | 0.95 (0.70–1.29) | |||
| Stroke | ||||||
|---|---|---|---|---|---|---|
| All N = 29,025 | No baseline stroke N = 27,208 | Baseline stroke N = 1,810 | ||||
| POU | Nonusers | POU | Nonusers | POU | Nonusers | |
| Participants, n | 1,850 | 27,168 | 1,685 | 25,523 | 165 | 1,645 |
| Events, n | 55 | 694 | 41 | 565 | 14 | 129 |
| IR (95%CI)‡ | 5.9 (4.5–7.7)∗ | 4.4 (4.0–4.7) | 4.7 (3.5–6.5) | 3.7 (3.3–4.0) | 19.9 (11.8–33.5) | 17.0 (14.2–20.2) |
| HR (95%CI) † | HR (95%CI) | HR (95%CI) | ||||
| Model 1 | 1.29 (0.97–1.69) | 1.24 (0.90–1.70) | 1.15 (0.66–2.02) | |||
| Model 2£ | 1.12 (0.85–1.48) | 1.13 (0.81–1.54) | 1.15 (0.65–2.01) | |||
| Model 3£ | 1.04 (0.78–1.38) | 1.07 (0.77–1.48) | 0.97 (0.54–1.74) | |||
| Model 4£ | 1.04 (0.78–1.38) | 1.07 (0.77–1.49) | 0.97 (0.54–1.75) | |||
|
CVD death | ||||||
|---|---|---|---|---|---|---|
| All N = 29,025 | No baseline CVD N = 22,403 | Baseline CVD N = 6,622 | ||||
| POU | Nonusers | POU | Nonusers | POU | Nonusers | |
| Participants, n | 1,851 | 27,174 | 1,295 | 21,108 | 556 | 6,066 |
| Events, n | 104 | 1016 | 35 | 470 | 69 | 546 |
| IR (95%CI)‡ | 9.6 (7.9–11.7)∗∗ | 5.4 (5.0–5.8) | 4.4 (3.2–6.2)∗ | 3.0 (2.7–3.4) | 27.1 (21.3–34.3)∗∗ | 16.2 (14.7–17.7) |
| HR (95%CI) † | HR (95%CI) | HR (95%CI) | ||||
| Model 1 | 1.75 (1.43–2.15) | 1.41 (1.00–1.99) | 1.69 (1.31–2.18) | |||
| Model 2¥ | 1.51 (1.23–1.86) | 1.35 (0.95–1.91) | 1.63 (1.27–2.10) | |||
| Model 3¥ | 1.23 (1.00–1.52) | 1.01 (0.70–1.44) | 1.40 (1.07–1.81) | |||
| Model 4¥ | 1.24 (1.00–1.53) | 0.99 (0.69–1.41) | 1.40 (1.08–1.82) | |||
Abbreviations: CI = confidence interval; CHD = coronary heart disease; CVD = cardiovascular disease includes history of CHD, stroke, periphery artery disease or aortic aneurism; HR = hazards ratio; IR = incidence rate; POU = Prescription opioid user.
∗Significant difference between POU and nonusers at P < 0.05; ∗∗ significant at P < 0.001.
Hazard Ratio and (95% Confidence Interval) for POU.
Age-adjusted Incidence Rate per 1,000 person-years (95% confidence interval).
Model 1 adjusts for age, race, sex, geographical region, education, income.
Model 2¶ adjusts for Model 1 covariates + total cholesterol, HDL-cholesterol, use of statins, smoking, diabetes, systolic blood pressure, use of antihypertensive medication, history of CHD (only for overall analysis).
Model 3¶ adjusts for Model 2 covariates + exercise, body mass index, log-transformed CRP, log transformed ACR, depressive symptoms (CES-D=>4) physical functioning (physical health component of SF-12), regular aspirin and NSAIDS use and chronic pain (moderate to severe) at baseline.
Model 4¶ adjusts for model 3 covariates + QT interval, corrected for heart rate.
Model 2£ adjusts for Model 1 covariates + total cholesterol, HDL-cholesterol, use of statins, smoking, diabetes, systolic blood pressure, use of antihypertensive medication, history of stroke (only in overall analysis), atrial fibrillation, left ventricular hypertrophy, history of CHD, periphery artery disease or aortic aneurism.
Model 3£ adjusts for Model 2 covariates + exercise, body mass index, log-transformed CRP, log transformed ACR, depressive symptoms (CES-D=>4) physical functioning (physical health component of SF-12), regular aspirin and NSAIDS use and chronic pain (moderate to severe) at baseline.
Model 4£ adjusts for model 3 covariates + QT interval, corrected for heart rate.
Model 2¥ adjusts for Model 1 covariates + total cholesterol, HDL-cholesterol, use of statins, smoking, diabetes, systolic blood pressure, use of antihypertensive medication, history of CVD (only for overall analysis).
Model 3¥ adjusts for Model 2 covariates + exercise, body mass index, log-transformed CRP, log transformed ACR, depressive symptoms (CES-D=>4), physical functioning (physical health component of SF-12), regular aspirin and NSAIDS use and chronic pain (moderate to severe) at baseline.
Model 4¥ adjusts for model 3 covariates + QT interval, corrected for heart rate. Bold P < 0.05.