Diabetes, Heart and Cardiovascular Diseases News Chronicle.  Diabetes, Cardiovascular and Heart Diseases
 Article 317
    Published on March 31, 2018

 

Starting long-acting inhaled bronchodilators tied to the risk of heart attack

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A Taiwanese nested case-control study shows 50 percent of (or 1.5 fold) enhanced risk to cardiovascular diseases among patients with chronic obstructive pulmonary disease (COPD) within first 30 days with the use of long-acting inhaled bronchodilators when compared with non-users. The enhanced risk is irrespective of the patient's history of exacerbations and previous cardiovascular disease.



The risk of arrhythmia, heart failure, coronary artery disease or ischemic stroke with bronchodilators.

But the absolute risk of cardiovascular disease was still around one percent among patients with chronic obstructive pulmonary disease (COPD) using long-acting inhaled bronchodilators. But the enhanced risk of cardiovascular disease will die over a period.


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A two-year follow-up study was done on the use of COPD on 284,220 patients from the Taiwan National Health Insurance Research Database, aged at least 40 years with an average age of 71.4 years at the start of the study. The percentage of the women participants was 31.1. The study participants were never users of the long-acting inhaled bronchodilators for the treatment of COPD, prior to the start of the study. They started the long-acting bronchodilators, either beta agonists (LABAs) or antimuscarinic antagonists (LAMAs) for the first time.

Follow-up study shows the development of severe heart problems such as arrhythmia, heart failure, coronary artery disease or ischemic stroke and the need for emergency medical care in 37,719 patients with COPD. The average age of those patients was 75.6 years. About 71.6 percent of them were men.


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The study also shows there was no difference in the risk of cardiovascular disease with either beta agonists or antimuscarinic antagonists or with the dosage.


The use of long-acting inhaled bronchodilators is essential for the treatment of COPD. The long-acting inhaled bronchodilators are designed to enlarge the airways in the lungs. These drugs can lower the severity of the disease and improve lung function. But they cause the inflammation and affect the cardiovascular health by increasing the blood pressure and heartbeat, narrowing of blood vessels and the formation of blockages in blood vessels.

The patients with chronic obstructive pulmonary disease (COPD) should know the immediate risk of cardiovascular disease when they start with inhaled long-acting bronchodilators. A patient with COPD should pay attention to the symptoms of heart disease such as arrhythmias (palpitations, irregular heartbeat), difficulty in breathing or chest pain. The patient should undergo regular check-ups with a specialist for a possible risk of cardiovascular disease after starting the inhalers. If the inhaled bronchodilators were prescribed by the doctor, the patient with chronic obstructive pulmonary disease (COPD) should not avoid it.


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Lead author of the study was Dr. Meng-Ting Wang, Ph.D., an Assistant Professor, School of Pharmacy, National Defense Medical Center, Taipei, Taiwan. The study was published January 2, 2018, in the JAMA Internal Medicine. Title of the article was "Association of Cardiovascular Risk With Inhaled long-acting Bronchodilators in Patients With Chronic Obstructive Pulmonary Disease. A Nested Case-Control Study." DOI : doi.org/10.1001/jamainternmed.2017.7720



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COPD : Chronic obstructive pulmonary disease (COPD) is a progressive lung disease affecting people aged more than 40 years. It is a third leading cause of death in the United States. This disease is caused due to the blockage of the air flow to the lungs. It lasts for years as the damage to the lungs due to disease cannot be reversed. A treatment can reduce disease symptoms, but the disease cannot be cured. Symptoms of COPD are.


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  • A chronic cough.
  • Whistling sound while breathing.
  • Harder to breathe.
  • Tightness in the chest.
  • Mucus (sputum) production.

Smoking is the main cause of COPD. It can also be due to prolonged exposure to irritating substances or gases. The worsening of COPD can be prevented by reducing smoking and improving the air quality. If left untreated, COPD will increase the risk of heart diseases, lung cancer and respiratory infections.

Chronic obstructive pulmonary disease : Please see COPD.


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