Advertisement

European Journal of Clinical Pharmacology

, Volume 49, Issue 4, pp 261–265 | Cite as

Increased risk of ischaemic heart disease mortality in elderly men using anxiolytics-hypnotics and analgesics

Results of the 10-year follow-up of the prospective population study “Men born in 1914”, Malmö, Sweden
  • J. Merlo
  • B. Hedblad
  • M. Ögren
  • J. Ranstam
  • P. O. Östergren
  • A. Ekedahl
  • B. S. Hanson
  • S. O. Isacsson
  • H. Liedholm
  • A. Melander
Pharmacoepidemiology And Prescription

Abstract

Objectives: An increased risk of all-cause and cardiovascular mortality in users of anxiolytic-hypnotic drugs (AHD) has been reported, and use of analgesics may be an additional factor. Therefore, we examined the association of AHD and analgesic use, alone and in combination, with all-cause and ischaemic heart disease (IHD) mortality.

Methods: Multivariate 10-year survival analysis in a population based cohort of 500 men born in 1914. Relative risks (RR) were adjusted by relevant confounders (blood pressure, serum cholesterol, diabetes mellitus, smoking habit, high alcohol consumption, history of previous IHD, cancer, and other diseases).

Results: The RR of both all-cause and IHD mortality were significantly increased among those using both AHD and analgesics compared to those who took neither of these drugs: RR=1.8 for all-cause mortality, and RR=2.7 for IHD mortality.

Conclusion: Although the number of cases was small, warranting interpretative caution, the current study suggests that the combined use of AHD (mainly benzodiazepines) and analgesics seems to be associated with an increase in all-cause and IHD mortality in elderly men.

Key words

Cardiovascular mortality Anxiolyticshypnotics pharmacoepidemiology adverse drug effect cohort study benzodiazepines analgesics 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Thororgood M, Cowen P, Mann J, Murphy M, Vessey M (1992) Fatal myocardial infarction and use of psychotropic drugs in young women. Lancet 340:1067–1068.CrossRefGoogle Scholar
  2. 2.
    Rumble R, Morgan K (1992) Hypnotics, sleep, and mortality in elderly people. J Am Geriatr Soc 40:787–791.PubMedGoogle Scholar
  3. 3.
    Isacsson S-O. Venous occlusion plethysmography in 55-year-old men (1972) A population study in Malmö, Sweden. Ph. D. Thesis. Acta Med Scand [suppl 537]:1–62.Google Scholar
  4. 4.
    Janzon L, Hanson BS, Isacsson S-O, Lindell S-E, Steen B (1986) Factors influencing participation in health surveys: results from the prospective study “Men born in 1914” in Malmö, Sweden. J Epidemiol Community Health 40:174–177.CrossRefPubMedCentralPubMedGoogle Scholar
  5. 5.
    Rose GA, Blackburn H (1968) Cardiovascular survey methods. WHO Monogr Series 56:162–165.Google Scholar
  6. 6.
    Johansson BW, Dziamski R (1984) Malignant arrhythmias in acute myocardial infarction. Relationship to serum potassium and effect of selective and non-selective beta-blockade. Drugs 28 [suppl]:77–85.CrossRefPubMedGoogle Scholar
  7. 7.
    Hedblad B, Janzon L (1992) Hypertension and ST segment depression during ambulatory electrocardiographic recording. Results from the prospective study “Men born in 1914” from Malmö, Sweden. Hypertension 20:32–37.CrossRefPubMedGoogle Scholar
  8. 8.
    Allain CC, Poon LS, Chan CSG, Richmond W, Fu PC (1974) Enzymatic determination of total cholesterol. Clin Chem 20:470–475.PubMedGoogle Scholar
  9. 9.
    Isacsson S-O, Hanson BS, Janzon L, Lindell S-E, Steen B (1987) Methods to assess alcohol consumption in 68-years old men: results from the population study “Men born in 1914” in Malmö, Sweden. Br J Addict 82:1235–1244.CrossRefPubMedGoogle Scholar
  10. 10.
    Kaplan EL, Meier P Nonparametric estimation from incomplete observations (1958). J Am Stat Assoc 53:457–481.CrossRefGoogle Scholar
  11. 11.
    Cox DR (1972) Regression models and life tables. J R Stat Soc (B) 34:187–220.Google Scholar
  12. 12.
    Mellinger GD, Balter MB, Uhlenhuth EH (1984) Prevalence and correlates of the long-term regular use of anxiolytics JAMA 251:375–379.CrossRefPubMedGoogle Scholar
  13. 13.
    Isacson D, Carsjö K, Bergman U, Blackburn JL (1992) Long-term use of benzodiazepines in a Swedish community: an eight-year follow-up. J Clin Epidemiol 45:429–436.CrossRefPubMedGoogle Scholar
  14. 14.
    Antiplatelet Trialist Collaboration (1994) Collaborative overview of randomised trials of antiplatelet therapy-I: Prevention of death, myocardial infarction, and stroke by prolonged antiplatelet therapy in various categories of patients BMJ 308:81–106.CrossRefGoogle Scholar
  15. 15.
    Johnson AG, Nguyen TV, Day -RO (1994) Do nonsteroidal anti-inflammatory drugs affect blood pressure? A meta-analysis. Ann Intern Med; 121:289–30.CrossRefPubMedGoogle Scholar
  16. 16.
    Williams P (1978) Physical ill-health and psychotropic drug prescription — a review. Psychol Med 8:683–693.CrossRefPubMedGoogle Scholar
  17. 17.
    Wells BK, Kamberg C, Brook R, Rogers W (1985). Health status, sociodemographics factors and the use of psychotropic drug. Med Care 23:1295–1306.CrossRefPubMedGoogle Scholar
  18. 18.
    Kripke DF, Simons RN, Garfinkel L, Cuyler-Hammond E (1979) Short and long sleep and sleeping pills. Is increased mortality associated? Arch Gen Psychiat 36:103–116.CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag 1996

Authors and Affiliations

  • J. Merlo
    • 1
  • B. Hedblad
    • 1
  • M. Ögren
    • 1
  • J. Ranstam
    • 2
  • P. O. Östergren
    • 1
  • A. Ekedahl
    • 1
  • B. S. Hanson
    • 1
  • S. O. Isacsson
    • 1
  • H. Liedholm
    • 1
  • A. Melander
    • 2
  1. 1.Departments of Community MedicineLund University, Malmö University HospitalMalmöSweden
  2. 2.The NEPI FoundationMalmö and StockholmSweden

Personalised recommendations