Widely prescribed drugs recommended as therapy for chronic obstructive pulmonary disease (COPD) are associated with an increased risk of heart attack, stroke and even death from heart disease, according to a new study, published in the September 24 issue of the Journal of the American Medical Association.

Inhaler drugs, such as Spiriva and Atrovent, are used to relax muscles and open lung airways in patients with obstructive pulmonary disease (COPD), a disease characterized by emphysema and chronic bronchitis, which obstructs airflow to the lungs. Its symptoms include restricted breathing, secretion of mucus, oxidative stress and inflammation of the airway.

Spiriva is used by more than 8 million patients globally since its approval by the Food and Drug Administration in 2002. The second most commonly prescribed drug in this class is ipratropium bromide (Atrovent).

In a new study, Dr. Dr. Sonal Singh, assistant professor of internal medicine at Wake Forest University Baptist Medical Center in Winston-Salem, N.C, and colleagues conducted a meta-analysis of available studies on inhaled anticholinergic drugs that had been used for the treatment of COPD for at least 30 days. There were 17 studies involving almost 15,000 patients that were followed for six weeks to five years.

“We found a 58 percent increased risk of cardiac death, heart attack or stroke” in people using these inhalers, the researchers said. The researchers found an 80 percent increased risk of cardiovascular death. For every 40 people who got one of the drugs in a year, there was one extra death, says co-author Curt Furberg, a Wake Forest University epidemiologist.