Prevention & lipidsMeta-analysis
Association between chronic opioid exposure and cardiovascular disease: a systematic review and meta-analysis
- Systematic review and meta-analysis
- random-effects
- meta-regression
- Risk of bias assessed using ROBINS-E
Authors' conclusion
COE is associated with increased risk of CVD, particularly cerebrovascular accidents and ischaemic heart disease.
Study context
- Population
- Human studies reporting associations between chronic opioid exposure and cardiovascular disease (CVD)
- Participants
- 1,676,000 participants · 17 studies
- Comparison
- Chronic opioid exposure vs no exposure
- Outcome
- CVD risk
Pooled result
CVD
Pooled odds ratio
1.74
95% CI 1.12–2.70
COE vs No COE
pooled OR 1.74 (95% CI 1.12–2.70)
As reported in the abstract
Further pooled results
Cerebrovascular accidents (subgroup)
- Cerebrovascular accidents, OR
- 1.84 (95% CI 1.45-2.35)
Ischaemic heart disease (subgroup)
- Ischaemic heart disease, OR
- 1.51 (95% CI 1.40-1.63)
CVD by chronic opioid exposure (COE) type (subgroup)
- Opium use had a significant association with CVD; findings for opioid use disorder (OUD) and prescription opioids were less consistent
Meta-regression
- Study design identified as a key moderator
Original publication
Association between chronic opioid exposure and cardiovascular disease: a systematic review and meta-analysis. Eur J Prev Cardiol. Published 9 August 2025. doi:10.1093/eurjpc/zwaf500
Summarised from the published abstract; every number is checked against it