US and UK researchers have found evidence that anticholinergics ipratropium bromide and tiotropium bromide (marketed as Atrovent and Spiriva) are linked to a significantly increased risk of cardiovascular death, heart attack (MI), and stroke among COPD patients.

The researchers reviewed data from all the studies that they found on inhaled anticholinergic for treatment of COPD. To be reviewed by the researchers, a study had to be a randomized, controlled trial where treatment lasted for at least 30 days and outcome measures included cardiovascular events.

This study is the first to examine the effect of inhaled anticholinergics on cardiovascular risk. Cardiovascular death, MI, or stroke occurred in 1.8% of patients that were on inhaled anticholinergics, compared to 1.2% of the control patients. Additionally, being on inhaled anticholinergics was linked to a 53% higher risk of having a heart attack and an 80% increased risk of cardiovascular death.

“Inhaled anticholinergics are associated with a significantly increased risk of cardiovascular death, MI, or stroke among patients with COPD,” conclude the authors.

The Journal of the American Medical Association will publish the full study.