September 29, 2008

Heart Risk Link to Inhaler

By HILL, Ruth

AN INHALER medication prescribed to thousands of New Zealanders with lung disease has been linked to an almost 60 per cent higher risk of heart attacks and strokes.

Research involving 14,800 people found that those taking Atrovent or Spiriva had a 58 per cent higher risk of cardiac death, heart attack or stroke than others on a placebo or other treatments. The findings were published in the Journal of the American Medical Association.

The Asthma and Respiratory Foundation advises patients taking Spiriva, Atrovent or Combivent to keep taking their medication but seek medical advice on their individual risk.

The drugs, known as anticholinergics, are the most advanced treatment available for chronic obstructive pulmonary disease (COPD), which affects more than 220,000 New Zealanders and is the fourth leading cause of death.

The foundation's medical director, Robin Taylor, said that though the increased risk sounded "dramatic", the overall risk was small.

"We're actually talking about an increase from 1.2 to 1.8 per cent.

"But for people with heart problems, particularly those with unstable angina, it may be the risk outweighs the benefit."

Anticholinergics relieve breathlessness by easing tension in the lung walls. They may interfere with electrical messages within the heart, but usually only when taken in very high doses.

Professor Taylor said other studies, including Belgian research released this week and sponsored by pharmaceutical firms Boehringer Ingelheim and Pfizer, had had quite different results. The four- year study involving nearly 6000 patients had found that those on Spiriva had a lower risk of heart problems.

"Against this background of conflicting information, the foundation believes its recommendations are in the best interests of all patients with COPD."

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