Anticholinergic Drug Burden Linked to Increased Risk for Cardiovascular Events

THURSDAY, March 12, 2026 (HealthDay News) -- In middle-aged and older adults, anticholinergic drug burden is associated with an increased risk for cardiovascular events, according to a study published online Feb. 28 in BMC Medicine.Nanbo Zhu, Ph.D., from the Karolinska Institute in Stockholm, and colleagues examined whether cumulative anticholinergic drug burden is associated with incident cardiovascular events in a population-based cohort study involving 508,273 Stockholm residents aged 45 years and older. The Anticholinergic Cognitive Burden scale was used to assess anticholinergic burden, which was quantified as annual consumption in defined daily doses (DDDs).The researchers found that during a median follow-up of 14.0 years, 118,266 incident cardiovascular events were recorded. After adjustment for sociodemographic, lifestyle, and clinical risk factors, higher levels of anticholinergic drug exposure were significantly associated with an increased risk for cardiovascular events in both baseline and time-updated models, with stronger associations seen in the latter. The hazard ratio increased with annual cumulative exposure in the time-updated model: 1.16, 1.31, and 1.71 for one to 89, 90 to 364, and ≥365 DDDs, respectively. Across event subtypes, a significant dose-response relationship was observed. The hazard ratios were 2.70, 2.17, 1.48, 1.32, 1.46, and 1.32 for heart failure, arrhythmias, artery disease, venous thromboembolism, myocardial infarction, and cerebrovascular disease, respectively, in the highest exposure group."Our results indicate that the cumulative drug burden can affect heart regulation, not only in the short term but also over the long term. This does not mean that the drugs should always be avoided, but that exposure should be monitored carefully," coauthor Hong Xu, M.D., Ph.D., also from the Karolinska Institute, said in a statement.Two authors disclosed ties to the pharmaceutical industry.Abstract/Full Text (subscription or payment may be required).Sign up for our weekly HealthDay newsletter

Anticholinergic Drug Burden Linked to Increased Risk for Cardiovascular Events

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