{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,27]],"date-time":"2025-09-27T04:08:15Z","timestamp":1758946095866,"version":"3.41.2"},"reference-count":32,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"11","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2020,6,2]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Patients prescribed opioids often have chronic conditions that increase their risk of adverse cardiovascular outcomes, but little is known about the primary preventive cardiovascular care these patients receive.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              We analyzed data from the 2014 to 2016 National Ambulatory Medical Care Survey to evaluate physicians\u2019 provision of primary preventive cardiovascular care to adults with and without opioid prescriptions. We included all visits made by adults 40 to 79\u00a0years old with at least 1 cardiovascular risk factor but no existing atherosclerotic cardiovascular disease. There were \u224832\u00a0million visits by adults who were prescribed opioids and \u2248167\u00a0million visits by adults not prescribed opioids on an annual basis. The prevalence of primary preventive care was modest in patients with versus those without opioid prescriptions, respectively: (1) statins for patients with dyslipidemia (52.1% versus 46.3%); (2) statins for patients with diabetes mellitus (49.1% versus 37.9%); (3) antihypertensive agents for patients with hypertension (76.5% versus 65.8%); (4) diet\/exercise counseling (40.5% versus 45.3%); and (5) smoking cessation therapy (25.3% versus 19.3%). In multivariate analyses, opioid use was associated with higher rates of statin therapy in patients with diabetes mellitus (adjusted relative risk [aRR], 1.25; 95% CI, 1.06\u20131.47;\n              <jats:italic>P<\/jats:italic>\n              =0.007) and antihypertensive medication in patients with hypertension (aRR 1.14; 95% CI, 1.06\u20131.22;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Overall adherence to guideline\u2010recommended primary preventive cardiovascular care during ambulatory visits was suboptimal. Findings show that patients prescribed opioids versus those without opioid prescriptions were more likely to receive statin therapy and antihypertensive agents in the setting of diabetes mellitus and hypertension, respectively. Ongoing efforts to bridge these gaps in primary prevention of cardiovascular disease remain a high priority.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.120.015961","type":"journal-article","created":{"date-parts":[[2020,5,27]],"date-time":"2020-05-27T09:03:06Z","timestamp":1590570186000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Differences in Cardiovascular Care Between Adults With and Without Opioid Prescriptions in the United States"],"prefix":"10.1161","volume":"9","author":[{"given":"Zekun","family":"Feng","sequence":"first","affiliation":[{"name":"Department of Medicine David Geffen School of Medicine at UCLA Los Angeles CA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dominic","family":"Williams","sequence":"additional","affiliation":[{"name":"Department of Medicine David Geffen School of Medicine at UCLA Los Angeles CA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8518-4800","authenticated-orcid":false,"given":"Joseph A.","family":"Ladapo","sequence":"additional","affiliation":[{"name":"Department of Medicine David Geffen School of Medicine at UCLA Los Angeles CA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsa1610524"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-008-0805-8"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1002\/pds.2131"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1111\/joim.12035"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.7789"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinternmed.2010.391"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2009.05.021"},{"key":"e_1_3_1_9_2","first-page":"444","article-title":"Prescription opioid use and risk of coronary heart disease, stroke, and cardiovascular death among adults from a prospective cohort (REGARDS Study)","volume":"17","author":"Khodneva Y","year":"2016","unstructured":"Khodneva Y, Muntner P, Kertesz S, Kissela B, Safford MM. Prescription opioid use and risk of coronary heart disease, stroke, and cardiovascular death among adults from a prospective cohort (REGARDS Study). Pain Med. 2016;17:444\u2013455.","journal-title":"Pain Med"},{"key":"e_1_3_1_10_2","first-page":"443","article-title":"Opioids and coronary heart disease","volume":"17","author":"King SA","year":"2016","unstructured":"King SA. Opioids and coronary heart disease. Pain Med. 2016;17:443.","journal-title":"Pain Med"},{"key":"e_1_3_1_11_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinternmed.2009.341"},{"key":"e_1_3_1_12_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1525-1497.1999.00263.x"},{"key":"e_1_3_1_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-015-3341-3"},{"key":"e_1_3_1_14_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.117.007107"},{"key":"e_1_3_1_15_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2018.0544"},{"key":"e_1_3_1_16_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-88-3-424"},{"key":"e_1_3_1_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2017.02.064"},{"key":"e_1_3_1_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2015.02.020"},{"key":"e_1_3_1_19_2","doi-asserted-by":"publisher","DOI":"10.7326\/M18-0222"},{"key":"e_1_3_1_20_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2018.13022"},{"key":"e_1_3_1_21_2","doi-asserted-by":"publisher","DOI":"10.7326\/M15-2223"},{"key":"e_1_3_1_22_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.0000437738.63853.7a"},{"key":"e_1_3_1_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2019.03.009"},{"key":"e_1_3_1_24_2","article-title":"Continuity of care for chronic conditions: threats, opportunities, and policy","author":"Ladapo JA","year":"2014","unstructured":"Ladapo JA, Chokshi DA. Continuity of care for chronic conditions: threats, opportunities, and policy. Health Affairs Blog. 2014. Available at: https:\/\/www.healthaffairs.org\/do\/10.1377\/hblog20141118.042672\/full\/. Accessed April 6, 2016.","journal-title":"Health Affairs Blog"},{"key":"e_1_3_1_25_2","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwg074"},{"key":"e_1_3_1_26_2","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwh090"},{"key":"e_1_3_1_27_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2288-3-21"},{"key":"e_1_3_1_28_2","unstructured":"National Center for Health Statistics (U.S.) . Ambulatory Health Care Data: NAMCS and NHAMCS Reliability of Estimates. 2013. Published on ftp site April 26 2012. Available at: http:\/\/www.cdc.gov\/nchs\/ahcd\/ahcd_estimation_reliability.htm. Accessed June 4 2013."},{"key":"e_1_3_1_29_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2017-016364"},{"key":"e_1_3_1_30_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0136339"},{"key":"e_1_3_1_31_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2016.4700"},{"key":"e_1_3_1_32_2","doi-asserted-by":"publisher","DOI":"10.2337\/dc18-1554"},{"key":"e_1_3_1_33_2","doi-asserted-by":"publisher","DOI":"10.3399\/bjgp14X676447"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.120.015961","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T11:33:53Z","timestamp":1715600033000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.120.015961"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,6,2]]},"references-count":32,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2020,6,2]]}},"alternative-id":["10.1161\/JAHA.120.015961"],"URL":"https:\/\/doi.org\/10.1161\/jaha.120.015961","relation":{},"ISSN":["2047-9980"],"issn-type":[{"type":"electronic","value":"2047-9980"}],"subject":[],"published":{"date-parts":[[2020,6,2]]},"assertion":[{"value":"2020-01-14","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-03-24","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-05-27","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e015961"}}