Benzodiazepines or related drugs and risk of cardiovascular diseases: a meta-analysis of cohort studies.

BACKGROUND

Benzodiazepines and related drugs (BZRDs) are widely prescribed for insomnia, anxiety, and other psychiatric disorders. However, their cardiovascular safety remains insufficiently characterized. This meta-analysis systematically evaluated the association between BZRD use and the risk of cardiovascular disease (CVD).

METHODS

We systematically searched PubMed, Embase, and the Library database from inception to Jan 2026, to identify relevant cohort studies. A random effects model was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for associations between BZRD use and CVD risk. Heterogeneity among studies was assessed using I2 statistics.

RESULTS

A total of 9 studies involving 11,509,700 individuals were included. BZRD use was associated with an increased risk of CVD (pooled odds ratio [OR], 1.40; 95% confidence interval [CI], 1.17–1.69). This association remained unchanged (pooled OR, 1.40; 95% CI, 1.31–1.48) when analyses accounted for drug indications. Regarding the CVD outcome, the results of the sensitivity and subgroup analyses confirmed the stability of the findings. Subgroup analysis based on CVD types revealed that the use of BZRD increased the risk of heart rhythm disorder (HRD) (OR, 2.44; 95% CI, 1.14–5.22), and ischemic heart disease (IHD) (OR, 1.15; 95% CI, 1.13–1.18), but did not elevate the risk of stroke (OR, 1.08; 95% CI, 0.98–1.2) or heart failure (HF) (OR, 1.27; 95% CI, 0.81–1.98).

CONCLUSION

This meta-analysis supports an association between BZRD use and an increased risk of CVD. Future well-designed studies are warranted to examine the impact of treatment duration, dosage, and specific BZRD agents on CVD risk.