Prednisone and Heart Disease
Dr. Bob Commentary: When patients get sick, they expect their doctor to do something dramatic that will help them feel better right away. Prednisone therapy (the major glucocorticoid) is one of those “miraculous” interventions that can cause a quick turnaround in the patient’s condition. But there is a price you have to pay for this “miracle.”

Prednisone does not really cure any underlying diseases (it strictly suppresses some symptoms), it makes any disorder harder to treat with natural medicine, and it is associated with multiple short and long term side effects. The below-quoted study with a huge number of subjects makes it clear that we can add an overall 60% increased incidence of cardiovascular events to its list of adverse effects. It should be noted that this group included simply “exposure” to synthetic corticoids as the inclusion criterea. Thus even patients taking the drug once, and short term, are at increased risk of later cardiovascular events. Here’s my advice: If you get sick, don’t panic, don’t take prednisone unless it is a critical emergency, and seek natural medicine treatment before getting on drugs with serious side effects. Do not go off of prednisone yourself without seeking the advice of a physician. The increased cardiovascular risk from prednisone is actually a lot higher than the Vioxx effect recently reported, but prednisone therapy is accepted as the “standard of care” for many serious health conditions, so such consequences are just accepted as inevitable. Don’t let that happen to you.

“Taking Glucocorticoids by Prescription Is Associated With Subsequent Cardiovascular Disease,” Wei L, MacDonald TM, Walker BR, Ann Intern Med, November 16, 2004;141(10):764-770.

In a study of 40,853 women and 27,928 men (mean age 62.54 years) who were exposed to glucocorticoids compared with 42,070 women and 40,132 men (mean age 59.36 years) who were nonusers without previous hospitalization for cardiovascular disease, 4,383 cardiovascular events occurred in 257,487 person-years of follow-up over this 3-year period for a rate of 17.0 per 1,000 person-years in the nonuser group and 5,068 events occurred in 212,287 person-years for a rate of 23.9 per 1,000 person-years in those exposed to the glucocorticoids, with a differentiation per dose of 22.1, 27.2 and 76.5 in the low, medium and high groups, respectively. The absolute risk difference was 6.9 per 1,000 person-years in the steroid-exposed group. The relative risk for cardiovascular disease events in those receiving high-dose glucocorticoids (e7.5 mg of prednisolone equivalent) was 2.56. Treatment with high-dose glucocorticoids is associated with an increased risk for cardiovascular disease.