| Cardiovascular mortality and morbidity in chronic obstructive pulmonary disease: the impact of bronchodilator treatment. | |
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MedLine Citation:
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PMID: 19849745 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Chronic obstructive pulmonary disease (COPD) is a substantial health burden. Cardiovascular disease (CVD), the leading cause of death, frequently coexists with COPD, an effect attributed to high individual disease prevalences and shared risk factors. It has long been recognized that COPD, whether stable or during acute exacerbations, is associated with an excess of cardiac arrhythmias. Bronchodilator medications have been implicated in the excess CVD seen in COPD, either as an intrinsic medication effect or related to side-effects. Despite the theory behind increased pro-arrhythmic effects in COPD, the reported results of trials investigating this for inhaled formulations at therapeutic doses are few. Methodological flaws, retrospective analysis and inadequate adjustment for concomitant medications, including short-acting 'relief' bronchodilators and non-respiratory medications with known arrhythmia propensity, mar many of these studies. For most bronchodilators at therapeutic levels in stable COPD, we can be reassured of their safety from current studies. The exception to this is ipratropium bromide, where the current data indicate an association with increased cardiovascular adverse effects. Moreover, there is no proven benefit from combining short-acting beta-agonists with short-acting anticholinergics at high doses in the acute setting, and although this practice is widespread, it is associated with increased cardiovascular risk. |
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Authors:
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R Wood-Baker; B Cochrane; M T Naughton |
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Publication Detail:
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Type: Journal Article; Review Date: 2009-10-22 |
Journal Detail:
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Title: Internal medicine journal Volume: 40 ISSN: 1445-5994 ISO Abbreviation: Intern Med J Publication Date: 2010 Feb |
Date Detail:
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Created Date: 2010-05-07 Completed Date: 2011-01-18 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101092952 Medline TA: Intern Med J Country: Australia |
Other Details:
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Languages: eng Pagination: 94-101 Citation Subset: IM |
Affiliation:
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Menzies Research Institute, Hobart, Tasmania, Australia. richard.woodbaker@utas.edu.au |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Administration, Inhalation Bronchodilator Agents / administration & dosage*, adverse effects Cardiovascular Diseases / epidemiology*, etiology, mortality* Humans Morbidity Pulmonary Disease, Chronic Obstructive / epidemiology*, mortality* |
| Chemical | |
Reg. No./Substance:
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0/Bronchodilator Agents |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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