Sleeping Pills Up Risk of Cardiovascular Events in Heart Failure Patients

Heart failure patients taking sleeping pills suffer an increased risk of cardiovascular events, a team of Japanese researchers claim.

The study led by Dr Masahiko Setoguchi reveals that among heart failure patients taking sleeping pill, there is an eight fold increased risk of cardiovascular events.  The finding is based on the examination of the medical records of 111 heart failure patients who were admitted to Tokyo Yamate Medical Center from 2011-2013.

Dr Masahiko Setoguchi said, "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. Cardiac function of heart failure patients worsens with repeated hospitalisations. We therefore decided it was important to investigate the relationships between drugs prescribed at discharge, rehospitalisation and cardiovascular events in heart failure patients."

Data was collected on the presence of coexisting cardiovascular and other medical conditions, medication administered during hospitalization and those prescribed at discharge, lab test results, electrocardiogram, echocardiogram and chest radiographic data and other key signs at the time of admission and discharge.

All the study participants were followed for nearly 180 days after which they were discharged from the hospitals.  The endpoint of the study was when the same participants were readmitted in the hospitals for heart failure or cardiovascular related death.

 To proceed with the finding, the researchers divided the study participants into two groups. One included those who had heart failure with preserved ejection fraction (HFpEF) and the other included heart failure with reduced ejection fraction (HFrEF).

They noticed that out of 47 HFpEF patients, 15 of them had reached the study endpoint during the 180 days follow up period. The difference between the participants who experienced an event and those who did not was the sleeping pills (benzodiazepine hypnotics), blood sodium levels during admission and blood haemoglobin levels at discharge.

Out of 64 HFrEF patients, 24 reached study endpoint during follow up. These patients taking high blood pressure medications had less than one-quarter the risk of cardiovascular events.

Further analysis made it clear that people who were given sleeping pills were eight times more vulnerable to rehospitalisation for heart failure or cardiovascular related death when compared to HFpEF patients who did not take sleeping pills.

Dr Setoguchi said, "Our study clearly shows that sleeping pills dramatically increase 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."

The finding was presented at the Heart Failure Congress 2014.