Skip to main content

Advertisement

SpringerLink
Log in

Elevation of Central Arterial Stiffness and Vascular Ageing in Opiate Withdrawal: Cross-sectional and Longitudinal Studies

  • Published:
Cardiovascular Toxicology Aims and scope Submit manuscript

Abstract

The central cardiovascular impacts of clinical opiate withdrawal have not been explored in detail. Pulse Wave Analysis (SphygmoCor) was conducted in healthy controls and opiate-dependent populations. A total of 1,294 patients (69.2 % male) were studied in quintuplicate on 2,089 occasions. Four groups were studied: control (N = 576), buprenorphine stabilized (N = 592), withdrawal (N = 112) and severe withdrawal (N = 14). Control patients were younger than the other groups (29.96 ± 0.45 years v. 32.53 ± 0.74–39.28 ± 3.86) but had similar sex ratios. Multiple regression was used to correct for the effects of age, and significant exacerbations were found in withdrawal in the vascular age (RA), augmentation index, subendocardial perfusion ratio (SEVR <100; R.R. 2.07 95 % C.I. 1.17–3.68, P = 0.02) and central systolic pressure both as factors themselves and in interactions with age (all P < 0.01). The elevation of modelled RA at 60 years was from 69.66 in controls to 97.54 in withdrawal (40.02 %). The effects on RA were found in both sexes and confirmed on longitudinal analysis. The elevation of RA in withdrawal was most marked after 40 years of age (P = 0.027). These results show increased vascular stiffness and cardiovascular age but reduced subendocardial perfusion in opiate withdrawal. Given the daily recurrent nature of withdrawal, these effects are likely cumulative.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Darke, S., Duflou, J., & Torok, M. (2011). Toxicology and characteristics of fatal oxycodone toxicity cases in New South Wales, Australia 1999–2008. Journal of Forensic Sciences, 56(3), 690–693.

    Article  PubMed  Google Scholar 

  2. Ghodse H. (2009). Annual Report of the INCB 2008.

  3. Office of Applied Studies Substance Abuse and Mental Health Services Administration. (2009). Trends in nonmedical use of prescription pain relievers: 2002–2007. National survey on drug use and health [serial on the Internet]. Cited August 30, 2009. Available from: http://www.oas.samhsa.gov/2k9/painRelievers/nonmedicalTrends.pdf.

  4. Schoedel, K. A., McMorn, S., Chakraborty, B., Potts, S. L., Zerbe, K., & Sellers, E. M. (2011). Positive and negative subjective effects of extended-release oxymorphone versus controlled-release oxycodone in recreational opioid users. Journal of Opioid Management, 7(3), 179–192.

    Article  PubMed  Google Scholar 

  5. CDC, Atlanta, Georgia. (2011). National health and nutrition examination survey. In US Department of Health and Human Services (Ed.). Toledo: CDC.

  6. Gu, Q., Dillon, C. F., & Burt, V. L. (2010). Prescription drug use continues to increase: US prescription drug data for 2007–2008. In CDC—Department of Health and Human Services (Ed.). NCHS Data Brief: CDC, pp. 1–8.

  7. Jamison, R. N., Serraillier, J., & Michna, E. (2011). Assessment and treatment of abuse risk in opioid prescribing for chronic pain. Pain Research and Treatment, 2011, 941808.

    Article  PubMed  Google Scholar 

  8. Hser, Y. I., Gelberg, L., Hoffman, V., Grella, C. E., McCarthy, W., & Anglin, M. D. (2004). Health conditions among aging narcotics addicts: Medical examination results. Journal of Behavioral Medicine, 27(6), 607–622.

    Article  PubMed  Google Scholar 

  9. Sadeghian, S., Darvish, S., Davoodi, G., Salarifar, M., Mahmoodian, M., Fallah, N., et al. (2007). The association of opium with coronary artery disease. European Journal of Cardiovascular Prevention and Rehabilitation, 14(5), 715–717.

    Article  PubMed  Google Scholar 

  10. Degenhardt, L., Randall, D., Hall, W., Law, M., Butler, T., & Burns, L. (2009). Mortality among clients of a state-wide opioid pharmacotherapy program over 20 years: risk factors and lives saved. Drug and Alcohol Dependence, 105(1–2), 9–15.

    Article  PubMed  Google Scholar 

  11. Darke, S., Duflou, J., & Torok, M. (2010). The comparative toxicology and major organ pathology of fatal methadone and heroin toxicity cases. Drug and Alcohol Dependence, 106(1), 1–6.

    Article  PubMed  CAS  Google Scholar 

  12. Claude Bernard, M. (1877). Lecons Sur Le Diabete et la Glycogenese Animale. Paris: Cours de Medecine.

    Google Scholar 

  13. Reece, A. S. (2008). Experience of road and other trauma by the opiate dependent patient: A survey report. Substance Abuse Treatment, Prevention, and Policy, 3, 10.

    Article  PubMed  Google Scholar 

  14. Howard, A. A., Floris-Moore, M., Lo, Y., Arnsten, J. H., Fleischer, N., & Klein, R. S. (2006). Abnormal glucose metabolism among older men with or at risk of HIV infection. HIV Medicine, 7(6), 389–396.

    Article  PubMed  CAS  Google Scholar 

  15. Rosen, D., Smith, M. L., & Reynolds, C. F., I. I. I. (2008). The prevalence of mental and physical health disorders among older methadone patients. American Journal of Geriatric Psychiatry, 16(6), 488–497.

    Article  PubMed  Google Scholar 

  16. Reece, A. S. (2007). Psychosocial and treatment correlates of opiate free success in a clinical review of a naltrexone implant program. Substance Abuse Treatment, Prevention, and Policy, 2, 35–49.

    Article  PubMed  CAS  Google Scholar 

  17. Cooper, O. B., Brown, T. T., & Dobs, A. S. (2003). Opiate drug use: A potential contributor to the endocrine and metabolic complications in human immunodeficiency virus disease. Clinical Infectious Diseases, 37(Suppl 2), S132–S136.

    Article  PubMed  CAS  Google Scholar 

  18. Kolarzyk, E., Pach, D., Wojtowicz, B., Szpanowska-Wohn, A., & Szurkowska, M. (2005). Nutritional status of the opiate dependent persons after 4 years of methadone maintenance treatment. Przeglad Lekarski, 62(6), 373–377.

    PubMed  Google Scholar 

  19. Fauci, A. S., Braunwald, E., Kapser, D. L., Hauser, S. L., Longo, D. L., & Jameson, J. L. (Eds.). (2008). Harrison’s principles of internal medicine (17th edn.). New York: McGraw Hill.

  20. Brunton, L. L., Lazo, J. S., & Parker, K. L. (Eds.) (2006). Goodman and Gilman’s the pharmacologic basis of therapeutics (11th edn.). New York: McGraw Hill.

  21. AtCor Medical Corporation. (2011 December 26). SphygmoCor pulse wave analysis system model SCOR-Px. Sydney: Atcor Medical 2006.

  22. Nichols, W. W. (2005). Clinical measurement of arterial stiffness obtained from noninvasive pressure waveforms. American Journal of Hypertension, 18(1 Pt 2), 3S–10S.

    Article  PubMed  Google Scholar 

  23. Sharman, J. E., Lim, R., Qasem, A. M., Coombes, J. S., Burgess, M. I., Franco, J., et al. (2006). Validation of a generalized transfer function to noninvasively derive central blood pressure during exercise. Hypertension, 47(6), 1203–1208.

    Article  PubMed  CAS  Google Scholar 

  24. Smart, N., Haluska, B., Jeffriess, L., Case, C., & Marwick, T. H. (2006). Cardiac contributions to exercise training responses in patients with chronic heart failure: A strain imaging study. Echocardiography, 23(5), 376–382.

    Article  PubMed  Google Scholar 

  25. Verbeke, F., Van Biesen, W., Honkanen, E., Wikstrom, B., Jensen, P. B., Krzesinski, J. M., et al. (2011). Prognostic value of aortic stiffness and calcification for cardiovascular events and mortality in dialysis patients: Outcome of the calcification outcome in renal disease (CORD) study. Clinical Journal of the American Society of Nephrology, 6(1), 153–159.

    Article  PubMed  Google Scholar 

  26. Chien, K. R., & Karsenty, G. (2005). Longevity and lineages: Toward the integrative biology of degenerative diseases in heart, muscle, and bone. Cell, 120(4), 533–544.

    Article  PubMed  CAS  Google Scholar 

  27. Kim, T. W., Alford, D. P., Malabanan, A., Holick, M. F., & Samet, J. H. (2006). Low bone density in patients receiving methadone maintenance treatment. Drug and Alcohol Dependence, 85(3), 258–262.

    Article  PubMed  CAS  Google Scholar 

  28. Reece, A. S. (2007). Evidence of accelerated ageing in clinical drug addiction from immune, hepatic and metabolic biomarkers. Immun Ageing., 4(1), 6–15.

    Article  PubMed  Google Scholar 

  29. Reece, A. S. (2007). Hair graying in substance addiction. Archives of Dermatology, 143(1), 116–118.

    PubMed  Google Scholar 

  30. Reece, A. S. (2012). Differing age related trajectories of dysfunction in several organ systems in opiate dependence. Aging Clinical and Experimental Research, 24(1), 85–96.

    PubMed  Google Scholar 

  31. Reece, A. S., & Davidson, P. (2007). Deficit of circulating stem–progenitor cells in opiate addiction: A pilot study. Substance Abuse Treatment, Prevention, and Policy, 2, 19–28.

    Article  PubMed  Google Scholar 

  32. Kienbaum, P., Thurauf, N., Michel, M. C., Scherbaum, N., Gastpar, M., & Peters, J. (1998). Profound increase in epinephrine concentration in plasma and cardiovascular stimulation after mu-opioid receptor blockade in opioid-addicted patients during barbiturate-induced anesthesia for acute detoxification. Anesthesiology, 88(5), 1154–1161.

    Article  PubMed  CAS  Google Scholar 

  33. Reece, A. S. (2011). Deterioration of indices of aortic augmentation and vascular age predate major cardiac events and interact with opiate dependence. International Journal of Cardiology [Case Report], 149, e8–e11.

  34. Reece, A. S. (2007). Dentition of addiction in Queensland: Poor dental status and major contributing drugs. Australian Dental Journal, 52(2), 144–149.

    Article  PubMed  CAS  Google Scholar 

  35. Cheng, F., McLaughlin, P. J., Verderame, M. F., & Zagon, I. S. (2009). The OGF-OGFr axis utilizes the p16INK4a and p21WAF1/CIP1 pathways to restrict normal cell proliferation. Molecular Biology of the Cell, 20(1), 319–327.

    Article  PubMed  CAS  Google Scholar 

  36. O’Donnell, C. J., & Nabel, E. G. (2011). Genomics of cardiovascular disease. New England Journal of Medicine, 365(22), 2098–2109.

    Article  PubMed  Google Scholar 

  37. Hutchinson, M. R., Zhang, Y., Shridhar, M., Evans, J. H., Buchanan, M. M., Zhao, T. X., et al. (2010). Evidence that opioids may have toll-like receptor 4 and MD-2 effects. Brain, Behavior, and Immunity, 24(1), 83–95.

    Article  PubMed  CAS  Google Scholar 

  38. Olinger, G. N., Mulder, D. G., Maloney, J. V., Jr, & Buckberg, G. D. (1976). Phasic coronary flow: intraoperative evaluation of flow distribution, myocardial function, and reactive hyperemic response. Annals of Thoracic Surgery, 21(5), 397–404.

    Article  PubMed  CAS  Google Scholar 

  39. Olinger, G. N., Po, J., Maloney, J. V., Jr, Mulder, D. G., & Buckberg, G. D. (1976). Myocardial revascularization in high-risk coronary patients. The Western Journal of Medicine, 124(4), 265–271.

    PubMed  CAS  Google Scholar 

Download references

Acknowledgments

The authors would like to thank Dr Mervyn Thomas of Emphron for assistance with the statistics and graphical design.

Conflict of interest

None.

Author information

Authors and Affiliations

  1. School of Psychiatry and Clinical Neurosciences, University of Western Australia, 39 Gladstone Rd., Highgate Hill, Brisbane, QLD, Australia

    Albert Stuart Reece & Gary Kenneth Hulse

Authors
  1. Albert Stuart Reece
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Gary Kenneth Hulse
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Albert Stuart Reece.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (PPT 733 kb)

Rights and permissions

Reprints and permissions

About this article

Cite this article

Reece, A.S., Hulse, G.K. Elevation of Central Arterial Stiffness and Vascular Ageing in Opiate Withdrawal: Cross-sectional and Longitudinal Studies. Cardiovasc Toxicol 13, 55–67 (2013). https://doi.org/10.1007/s12012-012-9186-7

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12012-012-9186-7

Keywords

Search

Navigation