Asthmatic child with inhaler

The findings are not conclusive, but a new study warns of the possibility that inhaler drugs could increase slightly the risk for heart attacks.

Inhaler lung drugs are often used by patients suffering from both emphysema and chronic bronchitis — a condition medically known as chronic obstructive pulmonary disease (COPD). This disease is the fourth leading cause of death in the U.S.

Patients afflicted by COPD characteristically have tremendous difficulty breathing — as if they are constantly underwater and struggling to breathe. The inhaler lung drugs relieve this difficulty, enabling patients to breathe again.

About 24 million Americans suffer from COPD, and over 100,000 die each year from the condition. In COPD, the airways of the lungs (bronchi) thicken and become narrow, and are filled with excess mucus. The patients undergo persistent coughing and experience severe breathing difficulty. Smoking is a primary cause of COPD.

The study found that the drugs — tiotropium, sold under the brand name Spiriva Handihaler, and ipratropium, sold in generic form or as the brand Atrovent — appeared to increase by a small degree the risks of strokes, heart attacks, or heart-related deaths.

The study was performed by researchers at Wake Forest University School of Medicine in North Carolina and the University of East Anglia in the UK. It is published in the Journal of the American Medical Association.

The study pools and analyzes the findings of 17 randomized studies, which compared patients using either of the two drugs with patients using other medicines.

Experts say randomized studies are the most stringent type of research in medicine. However, conclusions drawn from a pooled analysis of various randomized studies need careful evaluation because patients’ characteristics may differ widely.

The study observed that the use of either tiotropium or ipratropium seemed to push up the chances for heart problems (both fatal and nonfatal) by more than 50 percent.

Among 7,400 patients who used either drug, 135 people (1.8 percent) developed heart problems after using for several weeks to several years. In comparison, among 7,300 patients who used other medicines, 86 people (1.2 percent) suffered heart problems.

The results suggest that out of 40 patients who use the drugs on a long-term basis, one of them is likely to die due to a heart condition; also, out of 174 patients, one of them is likely to have a heart attack.

Other experts said the study’s findings are compelling but not conclusive. It does not establish if the drugs are the cause or some other factor was responsible. The drugs themselves do not affect the heart, which raises questions about the apparent rise in risks.

Most people who develop COPD are heavy smokers, and already have heightened risks for heart conditions to start with.

More research is needed to find out if the link between the inhaler drugs and increased risks is true.

Safety Tips:

* Quit smoking before taking drugs. This will reduce heart risks.

* Keep cholesterol levels and blood pressure under control. These are known heart risks and need to be managed.