Decongestants do not aggravate stroke, MI risk

The use of sympathomimetic decongestants does not seem to exacerbate the risk of stroke or myocardial infarction (MI), a recent study has found.

Researchers performed a nested case-crossover study including 1,394 MI patients and 1,403 stroke patients. Phone interviews were held to determine decongestant use in the 3 weeks before the cardiovascular event.

Eighty-nine participants confirmed the use of decongestants in the 3 weeks leading up to their stroke or MI. Twenty-eight exposures occurred in the immediate week preceding the episode; these patients were deemed to be at highest risk of the effect of decongestants. In comparison, 31 took decongestants 3 weeks before the cardiovascular event and were used as reference.

The composite of stroke and MI was not significantly more likely to occur in patients who took decongestants immediately prior to the episode, as opposed to the reference group (adjusted odds ratio [OR], 0.78, 95 percent CI, 0.43–1.42).

Similarly, decongestant exposure had no significant impact on either stroke alone (adjusted OR, 0.89, 95 percent CI, 0.42–1.85) or MI alone (adjusted OR, 0.66, 95 percent CI, 0.24–1.85). Odds estimates were calculated using conditional logistic regression models, adjusted for time-varying confounders such as infections.

Stratifying participants according to age, sex, and the prevalence of cardiovascular risk factors did not change the principal findings. Looking at different subtypes of stroke likewise revealed no significant impact of decongestant use.

“Further research is recommended on elderly patients and those with haemorrhagic stroke, a difficult task given the low use of these drugs by the elderly and the necessity to interview patients for the study of over-the-counter drugs,” the researchers said.