The Cardiovascular Effects of Long-acting Bronchodilators Inhalers and Inhaled Corticosteroids purchases among Asthma and COPD patient

<bold>Background:</bold> Inhaled corticosteroids (ICS), long-acting β-agonists (LABA) and muscarinic antagonists (LAMA) are the core treatments of chronic obstructive pulmonary disease (COPD) and asthma. Confounding reports of cardiovascular side effects have been reported. <bold>Methods:</bold> In this retrospective study we included adult male and female patients, with an asthma and/or COPD diagnosis who purchased LABA, LAMA and ICS alone or in combination between 2017- 2019. We calculated the odds ratios (OR) for CVD of patients who purchased at least one inhaler during the 12 months prior to the diagnosis and patients without any purchase of the same inhaler group. We also analyzed the risk among asthma patients and COPD patients. <bold>Results:</bold> The most prominent effects of ICS were reduced risks for myocarditis (OR 0.35, 95%CI 0.13, 0.89), ischemic heart disease (IHD) (OR 0.45, 95%CI 0.41, 0.49), valvular disease (OR 0.45, 95%CI 0.39, 0.55) and hypertension (HTN) (OR 0.47, 95%CI 0.42, 0.52). LABA inhalers had a significantly lower risk for conduction disorders and arrhythmias (OR 0.7, 95%CI 0.54, 0.92), HTN (OR 0.76, 95%CI 0.63, 0.92) and cerebrovascular diseases (OR 0.83, 95%CI 0.73, 0.93) while patients with COPD had significantly lower risk for heart failure (OR 0.62, 95%CI 0.48, 0.8). LAMA inhalers conferred a significantly lower risk of HTN (OR 0.65, 95%CI 0.57, 0.75), peripheral vascular diseases (OR 0.74, 95%CI 0.61, 0.92), IHD (OR 0.8, 95%CI 0.71, 0.89), and cerebrovascular disease (OR 0.84, 95 CI 0.77, 0.92). <bold>Conclusion:</bold> ICS, LABA and LAMA inhalers were associated with a significant reduction in the incidence of CVD.