# Melatonine en cardiovasculair risico: NHANES nuanceert recent hartfalen-signaal van AHA 2025

*geplaatst 2026-06-09 · Hartfalen · Open heart · doi 10.1136/openhrt-2026-004108 · https://hartvaat.nl/2026/05/21/melatonine-en-cardiovasculair-risico-nhanes-nuanceert-recent-hartfalen-signaal-v/*

Korte analyse als reactie op een groot elektronisch medisch dossier-onderzoek (gepresenteerd op AHA Scientific Sessions 2025) dat een hartfalen-veiligheidssignaal toonde bij langdurig melatoninegebruik bij volwassenen met slapeloosheid. De auteurs benadrukken dat observationele associaties tussen melatonine en cardiovasculaire uitkomsten extra vatbaar zijn voor confounding-by-indication, reverse causality en blootstellingsmisclassificatie — melatoninegebruik weerspiegelt vaak slapeloosheidsernst, depressie/angst en zorgconsumptie. In een nationaal representatief NHANES-cohort (1999-2018) bleek recent melatoninegebruik na correctie níet geassocieerd met cardiovasculaire ziekte of hartfalen. De data ondersteunen geen sterk claim van cardiovasculaire winst of schade. Klinisch advies: documenteer over-the-counter gebruik, counsel pragmatisch, en geef voorrang aan evaluatie en behandeling van onderliggende slaapstoornissen.

## English: 

Short analysis responding to a large electronic-health-record study (presented at AHA Scientific Sessions 2025) that reported a heart failure safety signal with long-term melatonin use in adults with insomnia. The authors emphasise that observational associations between melatonin and cardiovascular outcomes are particularly vulnerable to confounding-by-indication, reverse causality and exposure misclassification — melatonin use often reflects insomnia severity, depression/anxiety, and healthcare utilisation. In a nationally representative NHANES cohort (1999-2018), recent melatonin use was not significantly associated with cardiovascular disease or heart failure after adjustment. The data do not support strong claims of cardiovascular benefit or harm. Clinical guidance: document over-the-counter use, counsel pragmatically, and prioritise evaluation and treatment of underlying sleep disorders.

## Abstract (original, from the publication)

BACKGROUND: A large electronic health record study presented at the American Heart Association Scientific Sessions 2025 reported a heart failure safety signal associated with long-term melatonin use among adults with insomnia. In parallel, melatonin use has increased in the US general population, making counselling questions increasingly common in cardiovascular practice. MAIN ARGUMENT: Observational associations between melatonin and cardiovascular outcomes are unusually vulnerable to confounding-by-indication, reverse causality, and exposure misclassification because melatonin uptake often reflects insomnia severity, depression or anxiety symptoms and healthcare utilisation. EVIDENCE ANCHOR: In a nationally representative NHANES (National Health and Nutrition Examination Survey) adult cohort (1999-2018), melatonin users differed markedly from non-users at baseline, particularly for sleep disturbance and depression. In updated survey-weighted, multiple-imputation models, recent melatonin use was not significantly associated with prevalent composite cardiovascular disease or heart failure. These findings provide a hypothesis-generating contextual counterpoint to recent alarm signals rather than causal evidence of benefit or harm. CONCLUSION: Available observational data do not support strong claims of cardiovascular benefit, and they do not establish definitive cardiovascular harm or safety. Clinicians should document over-the-counter use, counsel pragmatically and prioritise evaluation and treatment of underlying sleep disorders while better evidence is developed.

Auteurs: Baryalay Khan, Bruno Bezerra Lima

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Bron: Open heart, https://doi.org/10.1136/openhrt-2026-004108. Bijgewerkt 2026-07-03T18:39:35Z. Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.