{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T14:17:52Z","timestamp":1773670672621,"version":"3.50.1"},"reference-count":37,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2022,5,27]],"date-time":"2022-05-27T00:00:00Z","timestamp":1653609600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacoepidemiology and Drug"],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Many commonly used prescription medications have cardiovascular adverse effects, yet the cumulative risk of cardiovascular events associated with the concurrent use of these medications is unknown. We examined the association between the concurrent use of prescription medications with known risk of a major adverse cardiovascular event (MACE) (\u201cMACE medications\u201d) and the risk of such events among older adults.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A multi\u2010center, population\u2010based study from the Atherosclerosis Risk in Communities (ARIC) study of a cohort of 3669 community\u2010dwelling adults aged 61\u201386\u2009years with no history of cardiovascular disease who reported the use of at least one medication between September 2006 and August 2013 were followed up until August 2015. Exposure defined as time\u2010varying and time\u2010fixed use of 1, 2 or \u22653 MACE medications with non\u2010MACE medications serving as negative control. Primary outcome was incident MACE defined as coronary artery revascularization, myocardial infarction, fatal coronary heart disease, stroke, cardiac arrest, or death.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In fully adjusted models, there was an increased risk of MACE associated with use of 1, 2, or \u22653 MACE medications (1 MACE: hazards ratio [HR], 1.21; 95% confidence interval [CI], 0.94\u20131.57); 2 MACE: HR 1.89, CI 1.42\u20132.53; \u22653 MACE: HR 2.22, CI 1.61\u20133.07) compared to use of non\u2010MACE medications. These associations persisted in propensity score\u2010matched analyses and among new users of MACE medications, never users of cardiovascular medications and subgroups of participants with increased risk of MACE. There was no association between the number of non\u2010MACE medications used and MACE.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions and Relevance<\/jats:title><jats:p>In this community\u2010based cohort of older adults with no prior cardiovascular disease, the use of MACE medications was independently and consistently associated with an increased risk of such events in a dose\u2013response fashion.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pds.5477","type":"journal-article","created":{"date-parts":[[2022,5,15]],"date-time":"2022-05-15T15:48:40Z","timestamp":1652629720000},"page":"1027-1038","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Use of prescription medications with cardiovascular adverse effects among older adults in the United States"],"prefix":"10.1002","volume":"31","author":[{"given":"Katharine","family":"Ozenberger","sequence":"first","affiliation":[{"name":"Program on Medicines and Public Health, Titus Family Department of Clinical Pharmacy, ADD School of Pharmacy University of Southern California  Los Angeles California USA"},{"name":"Department of Pharmacy Systems, Outcomes and Policy, College of Pharmacy University of Illinois at Chicago  Chicago Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G. Caleb","family":"Alexander","sequence":"additional","affiliation":[{"name":"Center for Drug Safety and Effectiveness Johns Hopkins Bloomberg School of Public Health  Baltimore Maryland USA"},{"name":"Department of Epidemiology Johns Hopkins Bloomberg School of Public Health  Baltimore Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jung\u2010Im","family":"Shin","sequence":"additional","affiliation":[{"name":"Center for Drug Safety and Effectiveness Johns Hopkins Bloomberg School of Public Health  Baltimore Maryland USA"},{"name":"Department of Epidemiology Johns Hopkins Bloomberg School of Public Health  Baltimore Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric A.","family":"Whitsel","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Gillings School of Global Public Health University of North Carolina  Chapel Hill North Carolina USA"},{"name":"Department of Medicine, School of Medicine University of North Carolina  Chapel Hill North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dima M.","family":"Qato","sequence":"additional","affiliation":[{"name":"Program on Medicines and Public Health, Titus Family Department of Clinical Pharmacy, ADD School of Pharmacy University of Southern California  Los Angeles California USA"},{"name":"Leonard D. Schaeffer Center for Health Policy and Economics University of Southern California  Los Angeles California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,5,27]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"HalesCM ServaisJ MartinCB KohenD.Prescription Drug Use Among Adults Aged 40\u201379 in the United States and Canada Key Findings Data from the National Health and Nutrition Examination Survey and the Canadian Health Measures Survey."},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2014.436"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(02)07370\u20101"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0140\u20106736(05)17864\u20107"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.c7086"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(13)60900\u20109"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.d2690"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0124653"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2014.09.036"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2013.1016"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2017.7720"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010017\u201017890\u20101"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1056\/nejmoa052827"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2016.0031"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000659"},{"key":"e_1_2_9_17_1","unstructured":"Centers for Disease Control (CDC).Heart Disease Facts; 2019. 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