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Use of Antibiotics May Increase Risk of Heart Disease among Older Women
2018-03-26 00:00:00
Ralph Chen

Antibiotics should only be taken when prescribed by a doctor to avoid infection from resistant bacteria. Antibiotics should only be used as directed by the prescribing doctor to reduce experiencing side effects. Sometimes, people overuse antibiotics, thus increasing the likelihood of resistance. And according to a new study, extended use of antibiotics may also increase the risk of cardiovascular disease.

Antibiotics May Increase Risk of Heart Disease

Researchers at the Tulane University suggested that older women who are taking antibiotics for at least two months have a higher risk of developing heart disease, compared to women who did not use such medication.

They examined the data of 37,516 women, aged 60 and older, who were enrolled in the Nurses’ Health Study. The said study is one described as extended observational that analyzes the long-term effects of several factors in women’s health such as diet, exercise, and use of medication.

The researchers reviewed the responses of women from questionnaires sent by the Nurses’ Health Study in 2004. The questionnaires were about the duration of antibiotics use with a scale from "not using at all" or "for at least two months." The questionnaires were also sent in two different periods with one for women ages 40 to 59 and the other for ages 60 and older. During that time, none of the 35, 516 women were diagnosed with any type of cancer or heart disease.

In the middle of 2014, the Nurses’ Health Study found that 4,535 women had died, with 1,179 from cancer and 600 from heart-related problems. Researchers found that the women who were taking antibiotics for at least two months had 19 percent higher mortality due to any disease, and 57 percent higher mortality from heart disease, compared to those who have not taken any antibiotics.

They also found that the increased risk of death, including mortality risk from heart disease, was more common among middle-aged women who used antibiotics for two months at least, compared to women who used antibiotics when they were aged 60 and older.

However, Dr. Lu Qi, the lead author of the study and a professor of epidemiology at Tulane University, said that the research does not prove a causal link between heart disease and use of antibiotics. This is because the study is observational and simply shows an association. Also, Dr. Qi explored the association between cancer and use of antibiotics but did not find any relationship.

“I think the study is fascinating. We don’t want people who really need antibiotics being afraid to take them,” Dr. Nieca Goldberg, Director of Joan H. Tisch Center for Women’s Health at New York University Langone Health.

Antibiotics and Abnormal Heart Rhythm

Antibiotics are designed to affect both pathogenic and harmful bacteria, depending on its target strain. However, use of antibiotics has been associated with a small increased risk of sudden cardiac death.

In 2015, a study explored the adverse effects of macrolides, antibiotics that treat several kinds of diseases including bronchitis, pneumonia, and selected sexually transmitted infections. Popular antibiotics like azithromycin, clarithromycin, and erythromycin are some of many macrolides.

In the study published in the Journal of the American College of Cardiology, the researchers analyzed 33 studies conducted from 1966 to 2015 which included more than 20 million patients. They compared patients who took macrolides antibiotics to other types of antibiotics or no antibiotics. Statistically, they found a significant yet small risk of sudden cardiac arrest with the use of macrolide antibiotics. But their analysis did not prove any causal link between the two.

"The absolute risks of sudden cardiac death and cardiac death are small, so it should likely have limited effect on prescribing practice. However, given that macrolides are one of the most commonly used antibiotic groups, and millions of patients are prescribed these drugs annually, the total number of sudden cardiac deaths or ventricular tachyarrhythmias and cardiac deaths may not be negligible," Dr. Su-Hua Wu, one of authors of the study from the department of cardiology at First Affiliated Hospital in China.

An accompanying journal editorial by Dr. Sami Viskin from Tel Aviv Medical Center in Israel found that 1 out 8,500 patients treated with macrolides could develop a serious case of heart rhythm problems after putting Dr. Wu’s study into perspective. Dr. Viskin also discovered that 1 out 30,000 patients who developed heart rhythm problem due to macrolides use might die.

Unfortunately, eliminating macrolides from the list of available antibiotics can cause a major problem in the medical world. There are several infections, such as Legionnaire’s disease, chlamydia, and bacteria associated with peptic ulcer Helicobacter pylori, which are best treated with macrolides. Moreover, treatment of acquired pneumonia is prone to a setback if macrolides are removed. The standard guidelines when treating the lung condition includes the use of azithromycin or a quinolone. Losing one class of antibiotics seems to be a reckless move, especially with the growing crisis of antimicrobial resistance.

[메디컬리포트=Ralph Chen 기자]

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