Source: DGNews  |  Posted 8 years ago

ENDO: Steroid-Treated Patients Have High Risk of Cardiovascular Event

By Maggie Schwarz

PHILADELPHIA, PA -- June 23, 2003 -- Patients who take glucocorticoids have a 32% incidence of having a cardiovascular event over a 10-year period, compared to 19% for those patients who do not take this class of drugs, according to findings reported here June 21st at the Endocrine Society's 85th Annual Meeting.

It has long been suspected that glucocorticoids increase heart disease risk, but the magnitude of the risk and whether there is a threshold dose below which steroids are safe to the heart have never been examined, said Brian R. Walker, MD, of the University of Edinburgh, Edinburgh, United Kingdom.

Dr. Walker and co-investigators from the UK, Netherlands and Canada conducted two studies to determine the incidence cardiovascular events among patients treated with glucocorticoids.

The first study, conducted in the Tayside region of Scotland, reviewed information on drug prescriptions, hospitalisations, and causes of death in more than 164,000 adults aged 40 and older who were randomly selected over a 4-year period. Nearly half had received a prescription for a glucocorticoid, such as a cream or inhaler, and approximately 2% received high doses of oral steroids.

Review of the data suggested that over a 10-year period, 19% of patients not taking a steroid would have a cardiovascular event, whereas 32% of those taking a steroid would experience an event. The risk was highest in those receiving high oral doses and negligible in the lowest dose group. The underlying disease for which the steroids were being prescribed did not account for the risk of having a cardiovascular event, the researchers found.

In the second study, similar information was collected over 9 years from the UK's General Practice Research Database. This analysis included more than 50,000 patients aged 50 years and older who had sustained a cardiovascular event and the same number of healthy controls.

The researchers found that patients with heart disease were 30% more likely than controls to have been taking oral glucocorticoids. The risk was greatest for heart failure and for the highest steroid doses, and was not related by the underlying disease.

Dr. Walker concluded that patients taking high doses of glucocorticoids should be treated aggressively for cardiovascular risk factors, and their physicians should be vigilant for signs of heart failure.

The studies were supported by the Scottish Executive and the British Heart Foundation.

[Study title: Glucocorticoid Therapy Increases Event Rates from Cardiovascular Disease; Results from Two Pharmacoepidemiological Studies of 265,445 Participants. Abstract OR30-2]