International Journal of Chronic Obstructive Pulmonary Disease
Open access peer-reviewed scientific and medical journals.
Dove Medical Press is now a member of the Open Access Initiative
An Author's Guide
A guide to help authors get their paper published.
Support Open Access and Dove Press
Promotional Article Monitoring - further details
Favored Author Program
Real benefits for authors, including fast-track processing of papers.
Cardiovascular morbidity and the use of inhaled bronchodilators
(5147) Total Article Views
Authors: Christine Macie, Kate Wooldrage, Jure Manfreda, Nicholas Anthonisen
Published Date March 2008
Volume 2008:3(1) Pages 163 - 169
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
Cannotea Citeulike Del.icio.us Facebook LinkedIn Twitter
Readers of this article also read:
- Journal Indexing
See where all the Dove Press journals are indexed.
"You do a tremendous job!!" Ruben Restrepo, University of Texas Health Science Center, San Antonio.
- Clinical effectiveness of the Respimat® inhaler device in managing chronic obstructive pulmonary disease: evidence when compared with other handheld inhaler devices
- Chronic obstructive pulmonary disease as an independent risk factor for cardiovascular morbidity
- The pathophysiology of bronchiectasis
- Exacerbation rate, health status and mortality in COPD – a review of potential interventions