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A new study finds people who have been prescribed opioid painkillers have a higher risk of early death compared with patients given other pain medications. Much of the increased risk is due to cardiovascular complications, HealthDay reports.

Patients given opioid painkillers were 64 percent more likely to die early for any reason, and 65 percent more likely to die from cardiovascular complications, compared with patients given other painkillers, researchers from Vanderbilt University in Nashville, Tennessee found. Complications that led to early death included breathing difficulties during sleep, heart rhythm irregularities and other cardiovascular complications.

“We were not surprised by the increased risk for overdose deaths, which is well known,” said study author Wayne Ray. “However, the large increase in cardiovascular death risk is a novel finding.”

The researchers analyzed data from almost 23,000 patients collected between 1999 and 2012. The patients, whose average age was 48, had just been prescribed a long-acting opioid. They were compared with patients given alternate pain medications, such as Neurontin (gabapentin), Lyrica (pregabalin) and Tegretol (carbamazepine) and low-dose antidepressants.

During the following four to six months, 185 patients given opioids had died, compared with 87 of those in the alternate medication group.

“The take-home message for patients with the kinds of pain we studied is to avoid long-acting opioids whenever possible,” Ray said in a news release. “This is consistent with recent Centers for Disease Control and Prevention guidelines. This advice is particularly important for patients with high risk for cardiovascular disease, such as those with diabetes or a prior heart attack.”

The findings are published in the Journal of the American Medical Association.