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Commonly prescribed drugs used for treatment of chronic obstructive pulmonary disease (COPD) increases the risk of deadly heart problems, a new study finds.
People with COPD suffer from crippling airflow obstruction; a COPD diagnosis, which is evolving and likely is underreported, historically has included labels such as emphysema, chronic bronchitis, and asthmatic bronchitis. COPD is the fourth-leading killer in the United States.
Many experts say that smoking and its residual effects cause about 90% of COPD deaths. However, the National Institute for Occupational Safety and Health reports that nearly 30% of COPD and adult asthma is caused by occupational exposure.
The use of two widely prescribed anticholinergics, Spiriva and Atrovent, for a month or more increased the risk of heart attack, stroke, or dying of cardiovascular problems by 58%, says Sonal Singh, MD, MPH, assistant professor of internal medicine at Wake Forest University School of Medicine in Winston-Salem, N.C.
Researchers pooled data of 17 clinical trials that included more than 14,000 patients and compared Spiriva and Atrovent, with other COPD treatments.
1.2 percent of control patients suffered a non-fatal heart attack or died from cardiovascular disease during the follow-up, which lasted from six weeks up to five years, 1.8 percent of those taking anticholinergics did – accounting for the 58 percent increase.
Boehringer and Pfizer, in response to the study, released a new analysis strongly disagreeing with the study findings that suggests an increased risk of cardiovascular problems associated with Spirivia use.
Another study recently published in the Annals of Internal Medicine found a 34% increased risk of death from a heart attack or irregular heartbeat in COPD patients taking ipratropium, a medication in the same class as Spiriva, compared with those taking albuterol, another widely used drug for COPD treatment or taking nothing.
The FDA, in March, notified health care providers that a pooled analysis comparing a placebo and Spiriva found a possible increased risk of stroke in patients taking the drug. At that time the FDA had not substantiated those findings.
The study is published in the Journal of the American Medical Association. #