Harvard Heart Letter

Heart Beat: New COPD medications seem okay for the heart

Heart Beat

New COPD medications seem okay for the heart

Diseases that interfere with the flow of air in and out of the lungs are lumped under the term chronic obstructive pulmonary disease (COPD). The two most common are emphysema and chronic bronchitis. Many people with COPD also have heart disease, so it's important that medications meant to keep the airways open and relaxed don't harm the circulatory system.

Results from a four-year trial showed that use of tiotropium (Spiriva), a relatively new drug used to keep airways open, reduced flare-ups of COPD and hospitalizations for it, but had no cardiovascular benefit or harm (New England Journal of Medicine, Oct. 9, 2008). That finding came just weeks after a meta-analysis of several trials suggested that heart attack, stroke, and deaths from cardiovascular disease were slightly more common in people taking tiotropium or ipratropium (Atrovent), which also helps keep airways open.

No drug is without side effects, and it is possible that larger, longer trials might reveal a cardiac downside to these two drugs. For now, though, if you are taking tiotropium or ipratropium and "it is making you feel better and reducing your symptoms, stick with it," says Dr. Elliot Israel, the director of pulmonary clinical research at Harvard-affiliated Brigham and Women's Hospital.

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