0
Summaries for Patients |

Glucocorticoid Medications and the Risk for Cardiovascular Disease FREE

[+] Article and Author Information

The summary below is from the full report titled “Taking Glucocorticoids by Prescription Is Associated with Subsequent Cardiovascular Disease.” It is in the 16 November 2004 issue of Annals of Internal Medicine (volume 141, pages 764-770). The authors are L. Wei, T.M. MacDonald, and B.R. Walker.


Ann Intern Med. 2004;141(10):I-58. doi:10.7326/0003-4819-141-10-200411160-00003
Text Size: A A A

What is the problem and what is known about it so far?

Glucocorticoids (also known as steroids or corticosteroids) include medications such as beclomethasone, prednisone, prednisolone, cortisone, and hydrocortisone. Glucocorticoids are related to corticosteroid hormones produced by the adrenal glands. Doctors prescribe glucocorticoids primarily to treat inflammatory conditions that affect the lungs, skin, joints, digestive tract, eyes, or other body systems. Common diseases that frequently require treatment with glucocorticoids include asthma, inflammatory bowel disease, and some types of arthritis. Glucocorticoids generally do not cause serious side effects when patients use them in small amounts or for short durations. However, patients who require high doses or longer duration of glucocorticoid treatment can develop side effects, including weight gain, mood changes, high blood pressure, high blood sugar levels, and thinning of the bones. Some people worry that glucocorticoids' effects on blood pressure, blood sugar, and body weight put users at high risk for cardiovascular disease, such as heart attack and stroke. While glucocorticoids have been associated with higher risk for cardiovascular disease, research on the existence and strength of the link between glucocorticoids medications and cardiovascular disease is limited.

Why did the researchers do this particular study?

To study the relationship between glucocorticoid medications and cardiovascular disease.

Who was studied?

68,781 people who used glucocorticoids and 82,202 who had not. Study participants resided in Tayside, Scotland, and were registered in a National Health Service database from 1993 to 1996.

How was the study done?

The researchers used information in the database to calculate the average daily dose of glucocorticoid medications given by mouth, by inhalation, or by application on the skin over the study period. They converted the amounts of different glucocorticoids into an equivalent dose of prednisolone to make comparisons easier. They also used the database to determine whether patients had had a cardiovascular event, such as a heart attack or stroke. The researchers then examined the relationship between glucocorticoid use and cardiovascular events while controlling for other factors that might influence cardiovascular disease.

What did the researchers find?

Patients who received high-dose glucocorticoids were more than twice as likely to have had a cardiovascular event as patients who used no glucocorticoids. They defined high-dose glucocorticoid use as the equivalent of 7.5 mg of prednisolone per day or more during 1 to 5 years of follow-up. Lower doses were not associated with an increase in cardiovascular events.

What were the limitations of the study?

This study did not definitively determine that glucocorticoids themselves, not the diseases that had necessitated treatment with high-dose glucocorticoid treatment, accounted for the higher risk for cardiovascular disease.

What are the implications of the study?

Patients receiving high-dose glucocorticoids seem to have an increased risk for cardiovascular events than patients who do not use glucocorticoids. Patients and doctors should consider this risk when they weigh the benefits and risks of glucocorticoid treatment.

Figures

Tables

References

Letters

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Comments

Submit a Comment
Submit a Comment

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.

Toolkit

Want to Subscribe?

Learn more about subscription options

Advertisement
Related Articles
Related Point of Care
Topic Collections
PubMed Articles
Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.
(Required)
(Required)