BENZODIAZEPINE usage has been significantly associated with increased risk of coronary heart diseases (CHD), heart failure (HF), and cardiovascular death, according to recent research.
Researchers analysed the data of 124,445 patients with insomnia from UK Biobank. Among this cohort, 2,041 patients were exposed to hypnotic agents (Z-meds or benzodiazepines), and 5,080 were non-hypnotics. The researchers used Cox proportional hazard model, inverse probability of treatment weighting, competing risk models, shared frailty models, and drug-target Mendelian randomization (MR) analyses to evaluate the data. It was found that after a median follow-up of 14.3 years, there were 929 CHD cases, 360 HF cases, 262 stroke cases, and 180 cardiovascular deaths. No significant associations were detected between Z-meds and CHD, stroke, or cardiovascular mortality. Whereas, benzodiazepine use was significantly associated with the increased risk of CHD (hazard ratio: 1.37), HF (hazard ratio: 1.60), and cardiovascular mortality (hazard ratio: 1.81).
This study highlights the cardiovascular risks associated with hypnotic use in patients with insomnia, linked to benzodiazepine use. Clinically, this suggests the need for cautious prescribing of benzodiazepines, with consideration of alternative therapies, especially in patients at risk for cardiovascular diseases.
Katrina Thornber, EMJ
Reference
Xie Y et al. Hypnotic use and the risk of cardiovascular diseases in insomnia patients. European Journal of Preventive Cardiology. 2024;DOI:10.1093/eurjpc/zwae263.
