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Study Finds Higher Stroke, Heart Attack Risks With Spiriva, Atrovent

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A new study indicates that the COPD (chronic obstructive pulmonary disease) drugs such as Spiriva and Atrovent can increase heart attack and stroke risks by 58 percent. Spiriva and Atrovent are known as inhaled anticholinergis, and are used daily by people with COPD to ease breathing.

“In absolute terms, what it means is that if you were to use these drugs for a year, your absolute risk of developing an additional cardiac death would be one in 40,” Dr. Sonal Singh, assistant professor of internal medicine at Wake Forest University Baptist Medical Center in Winston-Salem, N.C., told “US News and World Report”.  Dr. Singh was lead  author of an article detailing the study that appeared in the Sept. 24 issue of the “Journal of the American Medical Association”.

This Wake Forest study involved a meta-analysis of 17 randomized studies comparing a total of 15,000 mostly older patients who had taken either of the drugs with those on different medicine or a placebo.  All of the patients in the study were treated for at least 30 days.

Among about 7,400 patients on either inhaled drug, 1.8 percent or 135 people developed fatal or nonfatal heart problems over a period of several weeks to several years. By contrast, among about 7,300 patients on other drugs or dummy medicine, 1.2 percent or 86 had those problems.

According to the JAMA article, the use of inhaled anticholinergic drugs increased the risk of a heart attack by 53 percent, cardiovascular death by 80 percent and stroke by 46 percent. An increased risk of all-cause death was not clinically significant, but just barely so.

Based on these findings, Dr. Singh said before starting drugs, patients should try to reduce heart risks by quitting smoking, keeping blood pressure and cholesterol under control, and using oxygen. The study authors also urged doctors to closely monitor patients who use the inhalers.

COPD is a progressive lung disease, often caused by smoking, for which there’s no known cure. COPD affects as many as 24 million Americans and kills more than 100,000 each year.  Symptoms include restricted breathing, secretion of mucus, oxidative stress and inflammation of the airway.

Earlier this year, the Food & Drug Administration (FDA) issued an “early communication” warning of a possible increased risk of stroke with use of Spiriva. A Veterans Affairs study published last week linked Atrovent with an increased risk for heart-related deaths in men.

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