Glucocorticoids and the cardiovascular system: state of the art.

Abstract

Glucocorticoids (GC) are drugs commonly used, by approximately 1% of the total adult population as anti-inflammatory and immunosuppressive therapies for asthma, inflammatory bowel disease, dermatological, ophthalmic, neurological, and rheumatic autoimmune diseases. Supporting evidence exists of GC use in both immune mediated and non-immune mediated heart disease. The molecular mechanisms by which GC induces immune-modulation and direct cardioprotection, are complex and not fully understood. We review herein, the current knowledge of GC use in various immune-mediated or non-immune mediated cardiovascular conditions. GC have been investigated in autoimmune, inflammatory and idiopathic heart diseases such as atrio-ventricular conduction abnormalities, rheumatic fever, myocarditis, dilated cardiomyopathy, Churg-Strauss syndrome, Kawasaki disease and sarcoidosis. GC therapy has been studied in non-autoimmune and non-inflammatory indications such as acute myocardial infarction, angina, postpericardiotomy syndrome and other pericardial diseases, endocarditis and cardiac amyloidosis, as well as in invasive cardiology, coronary interventions, and cardiopulmonary-bypass surgery. Despite GC's role as natural, physiologic regulators of the immune system, cardiovascular adverse outcomes may occur. Some of the well-known side effects of GC therapy involve bone, metabolic, and cardiovascular systems and include osteoporosis, fractures, dyslipidemia, diabetes, obesity, and hypertension.

• Authors: Udi Nussinovitch, Jozélio Freire de Carvalho, Rosa Maria R Pereira, Yehuda Shoenfeld
• Journal: Current pharmaceutical design (Curr Pharm Des) Vol. 16 Issue 32 Pg. 3574-85 ( 2010) ISSN: 1873-4286 [Electronic] United Arab Emirates
• PMID: 20977421 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Review)

Chemical References

• Glucocorticoids

Topics

• Cardiovascular Diseases (drug therapy)
• Cardiovascular System (drug effects)
• Glucocorticoids (adverse effects, pharmacology, therapeutic use)
• Humans