The misuse of opioids continues to be epidemic, resulting in dependency and a recent upsurge in drug overdoses that have contributed to a significant decrease in life expectancy in the United States. Moreover, recent data suggest that commonly used opioids for the management of pain may produce undesirable pharmacological actions and interfere with critical medications commonly used in cardiovascular disease and stroke; however, the impact on outcomes remains controversial. The American Heart Association developed an advisory statement for health care professionals and researchers in the setting of cardiovascular and brain health to synthesize the current literature, to provide approaches for identifying patients with opioid use disorder, and to address pain management and overdose. A literature and internet search spanning from January 1, 2012, to February 15, 2021, and limited to epidemiology studies, reviews, consensus statements, and guidelines in human subjects was conducted. Suggestions and considerations listed in this document are based primarily on published evidence from this review whenever possible, as well as expert opinion. Several federal and institutional consensus documents and clinical resources are currently available to both patients and clinicians; however, none have specifically addressed cardiovascular disease and brain health. Although strategic tools and therapeutic approaches for recognition of opioid use disorder and safe opioid use are available for health care professionals who manage patients with cardiovascular disease and stroke, high-quality evidence does not currently exist. Therefore, there is an urgent need for more research to identify the most effective approaches to improve care for these patients.

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阿片类药物的使用及其与心血管疾病和大脑健康的关系：来自美国心脏协会的总统咨询

阿片类药物的滥用继续流行，导致依赖和最近药物过量的激增，导致美国预期寿命显着下降。此外，最近的数据表明，常用的用于治疗疼痛的阿片类药物可能会产生不良的药理作用，并干扰心血管疾病和中风常用的关键药物；然而，对结果的影响仍然存在争议。美国心脏协会为心血管和大脑健康领域的医疗保健专业人员和研究人员制定了一份咨询声明，以综合当前的文献，提供识别阿片类药物使用障碍患者的方法，并解决疼痛管理和过量服用的问题。从 2012 年 1 月 1 日开始的文献和互联网搜索，至 2021 年 2 月 15 日，仅限于对人类受试者进行的流行病学研究、审查、共识声明和指南。本文件中列出的建议和考虑主要基于本次审查的已发表证据以及专家意见。目前，患者和临床医生都可以使用一些联邦和机构共识文件和临床资源；然而，没有一个专门针对心血管疾病和大脑健康。尽管管理心血管疾病和中风患者的医疗保健专业人员可以使用用于识别阿片类药物使用障碍和安全使用阿片类药物的战略工具和治疗方法，但目前尚不存在高质量的证据。所以，