September 24, 2008

Inhalers to Fight Lung Disease ‘Could Cause Heart Attacks’

Anticholinergic drugs contained in the inhalers could increase the risk of a heart attack, cardio-vascular death or stroke by more than 50 per cent, research showed.The inhalers help people with chronic obstructive pulmonary disease (COPD), which includes chronic bronchitis and emphysema, to breathe. They open up airways by relaxing muscles, to allow air in and out of the patient's lungs more easily.The latest study looked at the inhalers ipratropium (Atrovent) and tiotropium (Spiriva). The meta-analysis examined at 17 medical trials involved a total of 14,783 patients who were using the inhalers for more than 30 days. Writing in the Journal of the American Medical Association (JAMA), the authors claimed: "Inhaled anticholinergic use for more than 30 days significantly increases the risk of cardiovascular death, myocardial infarction (heart attack), or stroke in patients with COPD by about 58 per cent." The research was carried out by experts from the Wake Forest University School of Medicine in North Carolina and Dr Yoon Loke, from the University of East Anglia in Norwich.Dr Loke said: "The vast majority of people with COPD are or have been heavy smokers, so they are already at heightened risk of heart attacks. We have found that the risk of suffering a heart condition goes up by 58 per cent with long-term use of this type of inhaler."Manufacturer of Spiriva, Boehringer Ingelheim said it strongly disagreed with the findings. Its latest analysis of 30 placebo-controlled double-blind, randomised trials with data from 19,545 COPD patients "demonstrated that there is no increased risk of death (all-cause) or death due to cardio-vascular events" in patients.The British Heart Foundation urged people with COPD to keep using their inhalers. "This recent review does not provide conclusive or robust evidence to link anticholinergic inhalers to an increased risk of cardiovascular disease."

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