Seniors with COPD -- a progressive lung disease that causes breathing problems -- may increase their odds for heart-related death if they use opioid painkillers, a new study finds.
COPD (chronic obstructive pulmonary disorder) patients are often prescribed opioids, including morphine and fentanyl. These narcotics can help treat chronic muscle and bone pain, insomnia, persistent cough and shortness of breath despite inhaler use, the researchers explained.
"Previous research has shown about 70 percent of older adults with COPD use opioids, which is an incredibly high rate of new use in a population that is potentially more sensitive to narcotics," said study lead author Dr. Nicholas Vozoris.
"Our new findings show there are not only increased risks for coronary artery disease-related death associated with new opioid use, but also increased risk of cardiac-related visits to emergency rooms and hospitalizations," said Vozoris. He is a respirologist at St. Michael's Hospital in Toronto.
For the study, Vozoris and his colleagues examined data from 144,000 COPD patients, aged 66 and older, in Canada. The researchers found that new opioid use was associated with a 215 percent increase in coronary artery disease-related death among long-term care patients compared to those not taking the prescription painkillers. Among patients living at home, the difference was 83 percent.
Two-thirds of the long-term care patients and 60 percent of the patients who lived at home were given a new opioid between April 2008 and March 2013, the researchers said.
Opioids pose heart risks because they can lower blood-oxygen levels and increase blood-carbon dioxide levels, Vozoris noted. They also can increase inflammatory factors in the blood vessels, leading to blockages that can cause a heart attack, he added.
"One other important reason (opioids) might be linked to future risk of heart attacks is because they offer pain relief, which could reduce or take away chest pain that acts as a warning before a cardiac event. Without that warning, doctors may not be able to intervene in time," Vozoris said in a hospital news release.
However, the study did not prove a cause-and-effect link between the drugs and heart risks, just an association.
Previous research by Vozoris found older adults with COPD who recently started using opioids are also at increased risk of dying from respiratory causes.
The study was published June 29 in the European Journal of Clinical Pharmacology.