Risk of cardiovascular events among patients with constipation relative to the general population cohort, by use of laxatives in the constipation cohort from 1 year before to 3 months after the constipation diagnosis*
| Cumulative incidence per 1000 persons in the constipation cohort (95% CI) | Adjusted HR (95% CI)† | |||
| 0 to 1 prescriptions for laxatives (n=68 698) | ≥2 prescriptions for laxatives (n=3125) | 0–1 prescriptions for laxatives (n=68 698) | ≥2 prescriptions for laxatives (n=3125) | |
| Myocardial infarction | 17.88 (16.20 to 19.69) | 12.78 (7.59 to 20.36) | 1.17 (1.07 to 1.28) | 2.40 (1.05 to 5.49) |
| Ischaemic stroke | 31.08 (28.63 to 33.68) | 19.59 (12.47 to 29.37) | 1.39 (1.30 to 1.49) | 3.22 (1.72 to 6.03) |
| Haemorrhagic stroke | 6.10 (4.99 to 7.40) | 4.05 (1.82 to 8.12) | 1.41 (1.20 to 1.65) | 4.59 (1.09 to 19.36) |
| Peripheral artery disease | 16.83 (10.82 to 25.08) | 7.28 (2.34 to 18.29) | 1.38 (1.22 to 1.55) | 0.88 (0.20 to 3.89) |
| Venous thromboembolism | 19.54 (16.99 to 22.35) | 28.15 (19.60 to 39.11) | 1.66 (1.52 to 1.82) | 5.15 (2.63 to 10.08) |
| Atrial fibrillation or atrial flutter | 42.44 (39.00 to 46.08) | 25.93 (18.42 to 35.44) | 1.12 (1.06 to 1.19) | 1.37 (0.76 to 2.45) |
| Heart failure | 29.58 (27.36 to 31.94) | 23.27 (14.67 to 35.10) | 1.36 (1.26 to 1.46) | 1.76 (0.90 to 3.42) |
The dash (–) indicates insufficient data for an estimate.
*The analysis was performed as a landmark analysis, starting follow-up 3 months after the constipation diagnosis.
†Controlled for matching factors (age, sex and calendar year) by study design and adjusted for hypothyroidism, hyperthyroidism, pregnancy within 90 days before the index date, depression, Parkinson’s disease, multiple sclerosis, colon, rectal and anal cancer, other gastrointestinal cancers, Crohn’s disease, ulcerative colitis, paralytic ileus, chronic pulmonary disease, valvular heart disease, diabetes mellitus, hypertension, hypercholesterolemia, obesity, chronic kidney disease, liver disease, alcoholism-related disorders, medications associated with constipation (iron supplements, opioids, calcium channel blockers, anticholinergic drugs, dopaminergic drugs, tricyclic antidepressants, diuretics, aspirin and non-steroidal anti-inflammatory drugs) and cardiovascular drugs (vitamin K antagonists, direct oral anticoagulants, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, beta-blockers, P2Y12 inhibitors, digoxin, amiodarone, nitrates and statins).
NSAIDs, non-steroidal anti-inflammatory drugs.