COPD Medicines: Risky or Safe?

Of course anticholinergic drugs leave sympathetic stimulation unbalanced. They, therefore, may act in certain individuals as weak sympathomimetic producing arrhythmias, hypertension, tachycardia, vasoconstriction etc. with know sequences, such as atherosclerosis, cerebrovascular and coronary effects. They should be avoided in individuals with well established risk factors.

How can we best determine if the correlation is a direct cause an effect.  Do the anticholinergics cause increase MI and cardiac disease or do the anticholinergics lead to something else that results in MI and carddiovascular disease.

In a recent article it is noted that for users of Ipatropium bromide there was an increase in all death and cardiac death in the group studied.  Theoretically at doses normally used there is not much of a corresponding mechanistic risk.  Therefore at this time additional study must be done in regard to anticholinergic inhaled medications and complications of such.  However this does...