Researchers at the University of Leeds have found that people prescribed low doses of steroids, mostly used to battle inflammatory disorders, are at an elevated risk of cardiovascular disease. The team's results, released this month in PLOS Medicine, indicate that levels of steroids traditionally thought safe over the long term may, in fact, pose significant health threats to those using them.
Steroids known as glucocorticoids are widely used for the treatment of a wide variety of IMIDs. While medical practitioners have long recognized the association between high doses of glucocorticoids and increased risk of cardiovascular disease (CVD), the relationship between low doses and this risk has been less studied.
Low doses administered to patients with IMIDs have usually been found healthy, but empiric proof of this is missing. Scientists at the University of Leeds, UK, have felt the need to explore how low doses of glucocorticoid influence a person's risk of CVD.
UK-based researchers have designed a study to measure the dose-dependent cardiovascular risk of glucocorticoid. They collected and examined medical reports for a total of 87,794 people diagnosed with one of six distinct IMIDs. Between 1998 and 2017, all patients obtained treatment in 389 primary care units in the United Kingdom.
The findings of the study found that patients administered less than 5 mg of glucocorticoid a day were at about double the risk of developing CVD compared to non-glucocorticoid patients. This dosage raised the risk of aortic aneurysm, atrial fibrillation, cerebrovascular disease, heart failure, and peripheral arterial disease in patients.
Previously, doses of 5 mg or less of glucocorticoid were deemed safe even when taking long-term. The current research undermines this widely held assumption that these low doses will significantly raise the likelihood of CVD for a patient, with just 5 mg doubling the odds of a person contracting such a disease.
The findings are critical to the future care of IMD patients. It indicates that doctors should often administer the lowest possible dosage and that customized prevention strategies can be vital to shield patients from the unduly high risk of CVD.
For the first time, the research community has found that those consuming any dosage of steroids, not just high doses, are at an elevated risk of acquiring a variety of CVDs. The findings of the current research also indicate that this risk increases with the dosage and length of medication.
Importantly, the analysis offers evidence against the widely held view that low doses did not pose a risk to cardiovascular health, as did high doses. This has important consequences for the treatment of patients with IMIDs that are twice as likely to experience CVD as the general population.
This study highlights the need for research and development into new long-term drugs for IMIDs with a better safety profile.
