Glucocorticoids are steroids widely prescribed to treat a range of immune-mediated inflammatory diseases. While high doses of steroids are known to increase the risk of cardiovascular disease, the impact of lower doses is unknown. A study published in PLOS Medcine by Mar Pujades-Rodriguez at Leeds University and colleagues suggests that even low doses of glucocorticoid may increase the risk of cardiovascular diseases.
To quantify glucocorticoid dose-dependent cardiovascular risk, researchers analyzed medical records of 87,794 patients diagnosed with 6 different immune-mediate inflammatory diseases receiving care from 389 United Kingdom primary care clinics in 1998-2017. The researchers found that for patients using less than 5 miligrams prenisolone per day, the absolute risk of cardiovascular disease nearly doubled compared to patients not using glucocorticoids (Hazard Ratio = 1.74; 95% confidence interval 1.64-1.84). Increased dose-dependent risk ratios were found across all CVDs measured, including atrial figrillation, heart failure, acute myocardial infarction, peripheral arterial disease,