Sleeping pills increases the risk of cardiovascular problems in the patients with heart failure by eight-fold, a new research shows.
Researchers at Japan analysed the medical records of 111 heart failure patients admitted to Tokyo Yamate Medical Center from 2011 to 2013. The data was gathered on the presence of coexisting cardiovascular and other medical conditions, medications given during hospitalisation and those prescribed at discharge, laboratory test results, electrocardiogram, echocardiogram and chest radiographic data and vital signs at admission and discharge.
The research team divided the patients into two groups. First group had heart failure patients with preserved ejection fraction (HFpEF) and second group comprised of those who had heart failure with reduced ejection fraction (HFrEF). "Management and prognosis can vary between patients with HFpEF and HFrEF so we analysed the two groups separately," Dr Masahiko Setoguchi said in a press release.
The participants were tracked for 180 days after they were discharged from hospital. The study endpoint was readmission for heart failure, or cardiovascular related death.
Of the 47 HFpEF patients, 15 reached the study endpoint during the 180 day follow up period. The only differences between patients who had events and those who did not were prescription of sleeping pills (benzodiazepine hypnotics), blood sodium levels at admission and blood haemoglobin levels at discharge.
Multivariate analysis showed that HFpEF patients who were prescribed sleeping pills had eight times more risk of rehospitalisation for heart failure or cardiovascular related death than HFpEF patients who were not prescribed sleeping pills (hazard ratio [HR]=8.063, p=0.010).
Of the 64 HFrEF patients, 24 reached the study endpoint during follow up. Multivariate analysis showed that HFrEF patients who were prescribed high blood pressure medications (ACE inhibitors or angiotensin receptor blockers) had less than one-quarter the risk of cardiovascular events compared to HFrEF patients not prescribed these drugs (HR=0.234, p=0.012).
"Sleeping problems are a frequent side effect of heart failure and it is common for patients to be prescribed sleeping pills when they are discharged from hospital. They also have other comorbidities and may be prescribed diuretics, antiplatelets, antihypertensives, anticoagulants and anti-arrhythmics," Dr Setoguchi said.
"The main finding of our study is that HFpEF patients prescribed sleeping pills have an increased risk of cardiovascular events. The number of HFpEF patients is increasing and becoming a larger proportion of heart failure patients overall. Our results therefore are of growing relevance to heart failure patients and the professionals who treat them," he added.
Dr Setoguchi said the study showed that sleeping pills drastically increases the risk of cardiovascular events in patients with HFpEF. "The finding was consistent across univariate and multivariate analyses. Given that many heart failure patients have difficulty sleeping, this is an issue that needs further investigation in larger studies."
