Duration of opiate exposure as a determinant of arterial stiffness and vascular age in male opiate dependence: a longitudinal study

作者：Reece A S^*; Hulse G K

来源：Journal of Clinical Pharmacy and Therapeutics, 2014, 39(2): 158-167.

DOI：10.1111/jcpt.12121

• vascular ageing
• heroin
• opiates
• dependence
• human ageing
• arterial stiffness

What is known and objective
Despite intriguing initial and associational studies, there remains little research on opiate-related arterial dysfunction and no longitudinal studies. As opiates act potently via P16INK4A/CDKN2A identified on GWAS screens, and as arterial ageing is a surrogate for organismal ageing, this area is of general concern.
Methods
Thirty-eight male controls compared with 198 opiate-dependent male patients were studied longitudinally using SphygmoCor pulse wave analysis.
Results and discussion
Healthy male controls and opiate-dependent male patients were studied on 125 and 625 occasions, respectively. The mean (+/- SEM) chronological age (CA) was 42 center dot 32 +/- 2 center dot 22 for controls and 35 center dot 04 +/- 0 center dot 61 for opiate dependent (P=0 center dot 0029). 94 center dot 4% and 13 center dot 2% smoked tobacco (P<0 center dot 0001). Controlling for BMI and CA, there was a significant time: addictive status interaction for vascular age (P=0 center dot 0127) and central augmentation pressure and index (both P<0 center dot 02). Central systolic and diastolic pressures were also worse over time by addictive status (P<0 center dot 005). At repeated measures multiple regression adjusted for classical risk factors, opiate dose and duration of opiate use remained significant. The dose-duration effect was significant in 8 terms and by time. A similar model quadratic in opiate duration was more powerfully predictive, suggesting the salience of the duration of opiate treatment (AIC 191 center dot 6898 and 191 center dot 5966, P=0 center dot 0116).
What is new and conclusion
Data suggest that increased length of opiate dependence is associated with advanced vascular stiffness and ageing and are therefore consistent with accelerated ageing organismally. The superiority of power functions of the opiate duration of exposure underscores the significance of the duration of treatment and of putative senescence induction.

• 出版日期2014-4