Back to Browse Journals » International Journal of Chronic Obstructive Pulmonary Disease » Volume 3 » Issue 1

Cardiovascular morbidity and the use of inhaled bronchodilators

Authors Christine Macie, Kate Wooldrage, Jure Manfreda, Nicholas Anthonisen

Published Date March 2008 Volume 2008:3(1) Pages 163—169

DOI http://dx.doi.org/10.2147/COPD.S1516

Published 18 March 2008

Christine Macie, Kate Wooldrage, Jure Manfreda, Nicholas Anthonisen

Department of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada

Abstract: We used the Manitoba Health database to examine the relationship between use of inhaled respiratory drugs in people with chronic obstructive respiratory diseases and cardiovascular hospitalizations from 1996 through 2000. The drugs examined were beta agonists [BA], ipratropium bromide IB, and inhaled steroids (ICS). End points were first hospitalizations for supraventricular tachycardia, myocardial infarction, heart failure or stroke. A nested case control analysis was employed comparing people with and without cardiovascular events. Cases and controls were matched for gender and age, and conditional logistic regression was used in multivariate analysis considering other respiratory drugs, respiratory diagnosis and visit frequency, non-respiratory, non-cardiac comorbidities, and receipt of drugs for cardiovascular disease. In univariate analyses, BA, IB and ICS were all associated with hospitalizations for cardiovascular disease, but in multivariate analyses ICS did not increase risk while both BA and IB did. There were interactions between respiratory and cardiac drugs receipt in that bronchodilator associated risks were higher in people not taking cardiac drugs; this was especially true for stroke. There were strong interactions with specific cardiac drugs; for example, both BA and IB substantially increased the risk of supraventricular tachycardia in patients not anti-arryhthmic agents, but not in the presence of such agents. We conclude that bronchodilator therapy for chronic obstructive diseases is associated with increased cardiovascular risk, especially in patients without previous cardiovascular diagnoses, and that this is unlikely due to the severity of the respiratory disease, since risk was not increased with ICS.

Keywords: bronchodilator therapy, inhaled corticosteroids, nested case control study

Download Article [PDF] 

Creative Commons License This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution - Non Commercial (unported, v3.0) License. The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. Permissions beyond the scope of the License are administered by Dove Medical Press Limited. Information on how to request permission may be found at: http://www.dovepress.com/permissions.php

Readers of this article also read:

Chronic obstructive pulmonary disease as an independent risk factor for cardiovascular morbidity

Joseph Finkelstein, Eunme Cha, Steven M Scharf

International Journal of Chronic Obstructive Pulmonary Disease 2009, 4:337-349

Published Date: 4 September 2009

Burden of diabetes in the adult Chinese population: A systematic literature review and future projections

Changyu Pan, Shuhua Shang, Wilhelm Kirch, et al

International Journal of General Medicine 2010, 3:173-179

Published Date: 22 June 2010

Hepatitis C virus infection and risk of cancer: a population-based cohort study

Lars Haukali Omland, Dora Körmendiné Farkas, Peter Jepsen, et al

Clinical Epidemiology 2010, 2:179-186

Published Date: 24 June 2010

Budesonide/formoterol combination in COPD: a US perspective

Amir Sharafkhaneh, Amarbir S Mattewal, Vinu M Abraham, et al

International Journal of Chronic Obstructive Pulmonary Disease 2010, 5:357-366

Published Date: 4 October 2010

Epigenomics in cancer management

Fabricio F Costa

Cancer Management and Research 2010, 2:255-265

Published Date: 27 October 2010

Evaluation of in-vitro antibiotic susceptibility of different morphological forms of Borrelia burgdorferi

Sapi E, Kaur N, Anyanwu S, Luecke DF, Datar A, Patel S, Rossi M, Stricker RB

Infection and Drug Resistance 2011, 4:97-113

Published Date: 3 May 2011

Causes of mortality among tuberculosis and HIV co-infected patients in Chiang Rai, Northern Thailand

Kantipong P, Murakami K, Moolphate S, Aung MN, Yamada N

HIV/AIDS - Research and Palliative Care 2012, 4:159-168

Published Date: 4 October 2012

Outcome mapping for health system integration

Tsasis P, Evans JM, Forrest D, Jones RK

Journal of Multidisciplinary Healthcare 2013, 6:99-107

Published Date: 14 March 2013

Enhanced penetration into 3D cell culture using two and three layered gold nanoparticles

England CG, Priest T, Zhang G, Sun X, Patel DN, McNally LR, van Berkel V, Gobin AM, Frieboes HB

International Journal of Nanomedicine 2013, 8:3603-3617

Published Date: 1 October 2013