与物质使用障碍相关的心血管疾病风险。

Risk of cardiovascular diseases in relation to substance use disorders.

机构信息

British Columbia Centre for Disease Control, Vancouver, BC, Canada.

British Columbia Centre for Disease Control, Vancouver, BC, Canada; School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada.

出版信息

Drug Alcohol Depend. 2021 Dec 1;229(Pt A):109132. doi: 10.1016/j.drugalcdep.2021.109132. Epub 2021 Oct 27.

DOI:10.1016/j.drugalcdep.2021.109132

PMID:34768052

Abstract

BACKGROUND

Substance use disorder (SUD) has become increasingly prevalent worldwide, this study investigated the associations of SUD and alcohol, cannabis, opioid, or stimulant use disorder with cardiovascular disease (CVD) and 11 major CVD subtypes.

METHODS

This study was based on a 20% random sample of residents in British Columbia, Canada, who were aged 18 - 80 years at baseline on January 1, 2015. Using linked administrative health data during 2010 - 2014, we identified people with various SUDs and prevalent CVDs at baseline, and examined the cross-sectional associations between SUDs and CVDs. After excluding people with CVDs at baseline, we followed the cohort for 4 years to identify people who developed incident CVDs, and examined the longitudinal associations between SUDs and CVDs.

RESULTS

The cross-sectional analysis at baseline included 778,771 people (mean age 45 years, 50% male), 13,279 (1.7%) had SUD, and 41,573 (5.3%) had prevalent CVD. After adjusting for covariates, people with SUD were 2.7 (95% confidence interval [CI], 2.5 - 2.8) times more likely than people without SUD to have prevalent CVD. The longitudinal analysis included 617,863 people, 17,360 (2.8%) developed incident CVD during the follow-up period. After adjusting for covariates, people with SUD were 1.7 (95% CI, 1.6 - 1.9) times more likely than people without SUD to develop incident CVD. The cross-sectional and longitudinal associations were more pronounced for people with opioid or stimulant use disorder.

CONCLUSIONS

People with SUD are more likely to have prevalent CVD and develop incident CVD compared with people without SUD.

摘要

背景

物质使用障碍（SUD）在全球范围内变得越来越普遍，本研究调查了 SUD 以及酒精、大麻、阿片类药物或兴奋剂使用障碍与心血管疾病（CVD）和 11 种主要 CVD 亚型的关联。

方法

本研究基于加拿大不列颠哥伦比亚省 20%的随机抽样居民，他们在 2015 年 1 月 1 日基线时年龄在 18-80 岁之间。使用 2010-2014 年期间的关联行政健康数据，我们在基线时确定了患有各种 SUD 和常见 CVD 的人群，并检查了 SUD 与 CVD 之间的横断面关联。在排除基线时患有 CVD 的人群后，我们对队列进行了 4 年的随访，以确定发生 CVD 的人群，并检查了 SUD 与 CVD 之间的纵向关联。

结果

基线时的横断面分析包括 778771 人（平均年龄 45 岁，50%为男性），13279 人（1.7%）患有 SUD，41573 人（5.3%）患有常见 CVD。在调整了协变量后，患有 SUD 的人群比没有 SUD 的人群发生常见 CVD 的可能性高 2.7 倍（95%置信区间 [CI]，2.5-2.8）。纵向分析包括 617863 人，在随访期间有 17360 人（2.8%）发生了新发 CVD。在调整了协变量后，患有 SUD 的人群比没有 SUD 的人群发生新发 CVD 的可能性高 1.7 倍（95%CI，1.6-1.9）。阿片类药物或兴奋剂使用障碍患者的横断面和纵向关联更为明显。