Melatonina e rischio cardiovascolare: un controllo della realtà NHANES dopo preoccupazioni recenti per l'insufficienza cardiaca.

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 ANC