Opioids in Cardiovascular Disease: Therapeutic Options

J Cardiovasc Pharmacol Ther. 2018 Jul;23(4):279-291. doi: 10.1177/1074248418757009. Epub 2018 Mar 11.

Abstract

The World Health Organization suggests that the cardiovascular diseases (CVDs) are the major cause of mortality and account for two-thirds of the deaths all over the world. These diseases kill about 17 million people every year and 3 in every 10 deaths are due to these diseases. The past decade has seen considerable improvements in diagnosis as well as treatment of various heart diseases. Various new therapeutic targets are being identified through in-depth knowledge of the disease mechanisms which has favored the testing of new strategies leading to newer treatment options. Opioid peptides and G-protein-coupled opioid receptors (ORs) have been previously studied widely in terms of central nervous system actions in mitigating the pain and drug abuse. The OR agonism or antagonism induces cytoprotective states in the myocardium, rendering these receptors as an attractive target for protection of heart from the fatal heart diseases. The opioids can provide an extended window of protection of the heart from various diseases. Although the mechanisms may not be fully understood, they seem to play a crucial role in various CVDs such as hypertension, hyperlipidemia, ischemic heart disease myocardial ischemia, and congestive heart failure. Since these compounds are already being used in acute and chronic pain, soon these compounds might be approved for use as cardioprotective agents. The following review focuses on the new information acquired on the role of the ORs in various CVDs.

Keywords: cardiovascular diseases; opioid agonist; opioid antagonist; opioid receptors.

Publication types

  • Review

MeSH terms

  • Analgesics, Opioid / adverse effects
  • Analgesics, Opioid / therapeutic use*
  • Animals
  • Cardiovascular Agents / adverse effects
  • Cardiovascular Agents / therapeutic use*
  • Cardiovascular Diseases / drug therapy*
  • Cardiovascular Diseases / metabolism
  • Cardiovascular Diseases / physiopathology
  • Cardiovascular System / drug effects*
  • Cardiovascular System / metabolism
  • Cardiovascular System / physiopathology
  • Humans
  • Narcotic Antagonists / adverse effects
  • Narcotic Antagonists / therapeutic use*
  • Receptors, Opioid / drug effects*
  • Receptors, Opioid / metabolism
  • Signal Transduction / drug effects
  • Treatment Outcome

Substances

  • Analgesics, Opioid
  • Cardiovascular Agents
  • Narcotic Antagonists
  • Receptors, Opioid