Leading COPD Drugs Tied to Stroke, Heart Attack

Sept. 24 -- TUESDAY, Sept. 23 (HealthDay News) -- Common drugs prescribed for chronic obstructive pulmonary disease (COPD) are associated with an increased risk of heart attack, stroke and other cardiovascular problems, researchers report.

These inhaled anticholinergic agents, such as Spiriva and Atrovent, are the most commonly prescribed once-daily treatment for COPD, a respiratory illness that's the fourth largest killer in the United States.

"We found a 58 percent increased risk of cardiac death, heart attack or stroke," in people taking these drugs, said Dr. Sonal Singh, assistant professor of internal medicine at Wake Forest University Baptist Medical Center in Winston-Salem, N.C. "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."

Singh was lead author of a paper published in the Sept. 24 issue of the Journal of the American Medical Association.

COPD is a progressive, destructive disease of the lungs, usually brought on by smoking, for which there's no known cure. Symptoms include restricted breathing, secretion of mucus, oxidative stress and inflammation of the airway.

Inhaled anticholinergics ease breathing in patients with COPD by preventing the airways from constricting.

In fact, inhaled tiotropium (Spiriva) is the most widely prescribed drug for COPD, used by more than 8 million patients globally since it was approved by the U.S. Food and Drug Administration in 2002. The second most commonly prescribed drug in this class is ipratropium bromide (Atrovent).

There have been previous scattered reports of an increased risk of cardiovascular events in people using Spiriva, resulting in an "early communication" from the U.S. Food and Drug Administration earlier this year warning of a possible increased risk of stroke with use of the drug.

In the new study, Singh and colleagues conducted a meta-analysis of available studies on inhaled anticholinergic drugs that had been used for the treatment of COPD for at least 30 days. Combined, the studies involved almost 15,000 patients.