Asthma Relief vs. Heart Safety: A Tough Tradeoff?

Actually , I believe it’s more of a strain to our heart and while body when it doesn’t get the oxygen and airflow it needs. I have not heard of inhalers causing problems for our heart.

I’m using a cortisone inhaler for many years along with a rescue inhaler, many times I have thought about the dangers of taking them. I really don’t have any other options that I know of and my doctor says that he uses the same medication. I suppose it’s just more of the same thing with medications, they do the job needed but there’s always the possibility of side effects.

@duckket313 Welcome to Mayo Connect. Some of us here are "research nerds" and like to look into questions just like this one.

I have Asthma and another lung condition, Bronchiectasis, and have long used bronchodilators and steroids - both from an inhaler, and during exacerbations from a nebulizer. I also have mild cardio-vascular disease. So I wondered the same thing.

Remember that there is a difference between the relatively low doses we use for maintenance and the long-term high doses of oral steroids used to treat many inflammatory conditions like Polymyalgia Rheumatica or Rheumatoid Arthritis - there is some clear evidence that these may increase risk of heart problems (CVD or cardio-vascular disease.)

As @frouke said, breathing more easily actually protects us from heart disease.

Here is one report that studied a lot of research on inhaled steroids:
https://pmc.ncbi.nlm.nih.gov/articles/PMC10484493/
There is some of evidence that long-term use of beta-agonists or combination therapy may increase CVD risk, but in this double-blind study, at least, it was shown that the risk was not statistically different between people using medications and those who did not.
https://heart.bmj.com/content/heartjnl/103/19/1536.full.pdf
I have more info somewhere on this topic, but do not have time to search for it today. As my excellent pulmonologists would tell you, every treatment, or decision not to treat, carries a risk. In my case, we have decided that using Symbicort (a combo of steroid and beta agonist) is better for my health and quality of life than not treating.

Remember that failure to control asthma can lead to sudden death from an attack, additional damage to lungs (hence my bronchiectasis - I lived in denial of my asthma for 20 years) and to sudden cardio-vascular death (my 50yo neighbor died of this during an uncontrolled asthma attack.)

Are you taking separate medications, or a combo inhaler? Do you also have a diagnosis of COPD?

Thank you so much for your detailed and insightful reply , I truly appreciate the time you took to share your experience and provide those links.

You make a great point about the importance of maintaining good airflow and oxygenation and how untreated asthma itself can be a serious strain on the heart and overall health. It is reassuring to hear from someone who has lived with both asthma and cardiovascular concerns and continues to find benefit in these medications under the guidance of a trusted pulmonologist.

I will definitely read through the studies you linked thank you for including those.The distinction between inhaled vs. high-dose oral steroids is something I had not fully considered and it helps put things in perspective.

To answer your question, I am currently using a combination inhaler but I do not have a COPD diagnosis at this point. I was mostly curious if the long term use of these meds, even at maintenance doses, could quietly affect heart function over time.

Thanks again , your reply really helped ground this concern in a more balanced and evidence-based way. Looking forward to learning more from this community.