New Study Finds...5 Things You Can Do to Keep it Together

"Did you hear about that study? You know, the one that says if you take Atrovent or Spiriva, you're more likely to have a heart attack or stroke? I don't know about you, but I've got enough trouble with my breathing, and I don't need anything else to happen. I'm going to stop taking it today!"

Sound familiar? We've all been at the coffee shop or in line at the grocery store and overheard somebody say something like this. In fact, chances are, it's been experienced by you, or someone close to you.

Whenever alarming results of a medical research study are released, there's a lot of buzz. We see a television news report or read something in the newspaper or online and say, "Hey, I take that medication. Should I be worried? Is it going to kill me? Should I stop taking it?"

As a person with a chronic disease and a consumer of pharmaceutical products that are supposed to help you and not hurt you, what are you supposed to do? In this article we're going to talk a little bit about the above study, then we're going to look at some tips in general on how you can stay calm and correctly informed when disturbing results of medical studies hit the news.

Do Atrovent and Spiriva cause Cardiovascular Death?

We're talking about the study by conducted by Singh and colleagues (JAMA, September 24, 2008) concluding that the use of inhaled Atrovent (ipratropium bromide) and Spiriva (tiotropium bromide) was associated with a significant increase in risk of cardiovascular death. Wow, that sure does sound scary!

But let's not get too excited just yet. Further findings of that study, cited in an article by by Peggy Peck, Executive Editor, MedPage Today (September 16, 2008) and reviewed by Dori F. Zaleznik, MD; Associate Clinical Professor of Medicine, Harvard Medical School says, "...the increased cardiovascular mortality risk seen with ipratropium "may be lessened by the concomitant [at the same time] use of inhaled corticosteroids...Long-acting beta agonists [such as Serevent] were also associated with reduced risk of...mortality and a non-significant trend toward a decreased risk of cardiovascular death."

It was further noted that the study had several limitations, including its observational design and the lack of data on severity of COPD, an unmeasured confounder that "could have also reduced the association between ipratropium and... mortality."

Additionally, the authors did not ascertain smoking status and they said the study might be underpowered for some of the cause-specific mortality analyses. Finally, it was noted that the results were most applicable "to men with recently diagnosed COPD and may not apply to patients with more severe disease or to women."

In conclusion, it was cautioned, "given the risk observed in our study and in previous studies of ipratropium, caution is warranted in the use of ipratropium alone in patients with recently diagnosed COPD."

Response from the manufacturer