Reduction in arterial stiffness and vascular age by naltrexone-induced interruption of opiate agonism

Objective: To prospectively assess if opiate antagonist treatment or the opiate-free status could reverse opiate-related vasculopathy. Design: Longitudinal Open Observational, Serial “N of One”, over 6.5 years under various treatment conditions: opiate dependence, naltrexone and opiate-free. Setting: Primary care, Australia. Participants: 20 opiate dependent patients (16 males: 16 cases of buprenorphine 4.11+1.17mg, two of methadone 57.5+12.5mg and two of heroin 0.75+0.25g). Intervention: Studies of Central Arterial Stiffness and vascular reference age (RA) were performed longitudinally by SphygmoCor Pulse Wave Analysis (AtCor, Sydney). Primary Outcomes: Primary outcome was vascular age and arterial stiffness accrual under different treatment conditions. Results: The mean chronological age (CA) was 33.62+2.03 years. The opiate-free condition was associated with a lower apparent vascular age both in itself (males: P=0.0402, females: P=0.0360) and in interaction with time (males: P=0.000...