title: [Are there cardiovascular adverse effects of inhaled anticholinergics?].
abstract: The purpose of this review is to discuss the cardiovascular risk associated with inhaled anticholinergics in chronic obstructive pulmonary disease. Several meta-analyses of data for tiotropium raised the possibility of an increased risk for arrhythmia, angina, myocardial infarction, etc. This review includes the data of retrospective studies of databases using databases, randomized controlled trials, and meta-analyses of clinical trials. The conclusions of studies were inconsistent. In most clinical trials the incidence of cardiovascular adverse events was similar in active treatment and placebo groups, especially in patients with previous cardiovascular diseases. Considering meta-analyses, there is little, if any, evidence for the association between anticholinergics and the development of cardiovascular symptoms. The author discusses the presence and function of cholinergic receptor subtypes in human heart, and cardiac functions controlled by the autonomic nervous system via these receptors, their possible role, and pharmacokinetic properties of inhaled anticholinergics. The author concludes that it is not possible to find evidence of increased cardiovascular harm of inhaled anticholinergics.
authors.affiliation: Felsődobsza, Thököly u. 1., 3847.
authors.forename: László Béla
authors.initials: LB
authors.lastname: Nagy
mesh_terms: D000280:Administration, Inhalation; D001993:Bronchodilator Agents / Q000008:administration & dosage* / Q000009:adverse effects*; D002318:Cardiovascular Diseases / Q000139:chemically induced* / Q000453:epidemiology; D002319:Cardiovascular System / Q000187:drug effects* / Q000503:physiopathology; D018680:Cholinergic Antagonists / Q000008:administration & dosage* / Q000009:adverse effects*; D002986:Clinical Trials as Topic; D006024:Glycopyrrolate / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D015994:Incidence; D009241:Ipratropium / Q000009:adverse effects; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy*; D011812:Quinuclidines / Q000008:administration & dosage / Q000009:adverse effects; D012307:Risk Factors; D012602:Scopolamine Derivatives / Q000008:administration & dosage / Q000009:adverse effects; D000069447:Tiotropium Bromide
chemical_list: D001993:Bronchodilator Agents; D018680:Cholinergic Antagonists; C573971:GSK573719; D011812:Quinuclidines; D012602:Scopolamine Derivatives; D009241:Ipratropium; D006024:Glycopyrrolate; D000069447:Tiotropium Bromide
keywords: adverse cardiovascular events; cardiovascularis szövődmények; chronic obstructive pulmonary disease; inhaled anticholinergics; inhalációs antikolinerg szerek; krónikus obstruktív tüdőbetegség