Even low doses of steroids increase risk of cardiovascular disease, finds study

Previously, it was believed that taking 5 mg of glucocorticoid over the long-term was safe, but the study suggests that even patients taking low doses have double the risk of developing cardiovascular disease. These findings suggest patients needing long-term steroid treatment should be prescribed the lowest effective dose and have a personalized cardiovascular risk prevention plan that accounts for past and current steroid use. Although the study was limited by the lack of available hospital data on prescription drug adherence and may have reduced the size of dose-response estimates, the authors believe that the large sample size contributes to greater generalizability of the results.

According to the authors, "Our findings highlight the importance of implementing and evaluating targeted intensive cardiovascular risk factor modification interventions; promptly and regularly monitor patient cardiovascular risk, beyond diagnosis of inflammatory arthropathies and systemic lupus erythematosus, even when prescribing low prednisolone-equivalent doses".

Citation: Pujades-Rodriguez M, Morgan AW, Cubbon RM, Wu J (2020) Dose-dependent oral glucocorticoid cardiovascular risks in people with immune-mediated inflammatory diseases: A population-based cohort study. PLoS Med 17(12): e1003432. https://doi.org/10.1371/journal.pmed.1003432