Narcolepsy tied to increased risk of subclinical CVD

Individuals with narcolepsy, including children, appear to have an elevated risk of subclinical cardiovascular disease (CVD), according to a retrospective study.

Researchers used data from the MarketScan Commercial and Medicare Supplemental databases. They included 22,293 individuals (mean age 33 years, 35.44 percent male) with a diagnosis of narcolepsy (NT1 and NT2) and 63,709 propensity-score matched individuals (mean age 34 years, 37.12 percent male) without narcolepsy (control) in the analysis.

The main outcomes were hypertension, hyperlipidaemia, diabetes, and nonalcoholic fatty liver disease (NAFLD)/nonalcoholic steatohepatitis (NASH), as well as a composite measure for CVD and major adverse cardiovascular events (MACE).

Compared with controls, patients with narcolepsy had an increased risk of all subclinical outcomes. Specifically, the risk increase associated with narcolepsy was 40 percent for hypertension (hazard ratio [HR], 1.40, 95 percent confidence interval [CI], 1.34–1.47), 41 percent for hyperlipidaemia (HR, 1.41, 95 percent CI, 1.35–1.47), 50 percent for diabetes (HR, 1.50, 95% CI, 1.38–1.64), 48 percent for NAFLD/NASH (HR, 1.48, 95 percent CI, 1.28–1.73), 61 percent for the composite of CVD (HR, 1.61, 95 percent CI, 1.35–1.47), and 69 percent for MACE (HR,1.69, 95 percent CI, 1.43–2.00).

Consistent results were obtained in an analysis adjusted for narcolepsy medications including stimulants, wake‐promoting agents, and oxybates, as well as in an analysis stratified by age groups.

The results underscore the importance of detecting these subclinical CVD outcomes early in the course of narcolepsy in order to minimize the burden of adverse cardiovascular events later in life, the researchers said.