Cardiovascular Risks Associated with Long-Term Use of Corticosteroids and Immunosuppressants: A Comprehensive Review

• DOI: https://doi.org/10.22533/at.ed.1594762413082

• Palavras-chave: Cardiovascular disease; Corticosteroids; Immunosuppressants; Hypertension; Insulin resistance.

• Keywords: Cardiovascular disease; Corticosteroids; Immunosuppressants; Hypertension; Insulin resistance.

• Abstract: INTRODUCTION The introduction highlights the widespread use of corticosteroids and immunosuppressants in managing various chronic conditions, noting their efficacy in controlling disease activity but also their significant long-term side effects. It focuses on the cardiovascular risks associated with these medications, including hypertension, dyslipidemia, and insulin resistance. The introduction sets the stage for a comprehensive review of the pathophysiological mechanisms and strategies for managing these risks. OBJETIVE To assess the increased cardiovascular risk in patients using corticosteroids and immunosuppressants for long periods. METHODS This is a narrative review which included studies in the MEDLINE – PubMed (National Library of Medicine, National Institutes of Health), COCHRANE, EMBASE and Google Scholar databases, using as descriptors: “Cardiovascular risk” AND “Long-term corticosteroid use” AND “Immunosuppressant therapy” AND “Hypertension and dyslipidemia” OR “Chronic inflammation and metabolic syndrome” in the last years. RESULTS AND DISCUSSION The results and discussion sections elaborate on the increased incidence of cardiovascular events in patients on long-term corticosteroid therapy, supported by multiple studies demonstrating a higher risk of myocardial infarction, stroke, and heart failure. It delves into the biological mechanisms, such as sodium retention, oxidative stress, and endothelial dysfunction, that contribute to these risks. The discussion also compares the cardiovascular impacts of different immunosuppressants and underscores the importance of personalized treatment plans and regular monitoring to mitigate these risks. CONCLUSION The conclusion reiterates the critical need for careful management of cardiovascular risk in patients using long-term corticosteroids and immunosuppressants. It emphasizes the role of personalized medicine, lifestyle modifications, and pharmacological interventions in optimizing therapeutic outcomes. The conclusion calls for ongoing research to develop targeted interventions and explore alternative therapies with lower cardiovascular toxicity to ensure the safe and effective use of these essential medications.