Cardiovascular risk with PMR

I know that prednisone can increase blood sugar, blood pressure, and also cholesterol, and all of those increase the risk of heart disease. My cholesterol went up when I was on prednisone almost enough to where I needed to start taking a statin. But it went back down as I tapered to where I didn't need treatment.

All of those side effects can be treated as needed, along with possible decreased bone density, and possible vision problems like cataracts and glaucoma. Prednisone works well for PMR and GCA, but the side effects need to be monitored.

@jeff97
I have a habit of trusting my docs but am learning that often they do not have time or inclination to educate patients. I appreciate your information. Since prednisone I have more quickly increasing osteoporosis and clogged arteries. Now I am a qualified oldster and I don't like it very much. A sense of humor can help.

The increased cardiovascular risk is approximately 2x greater for people with PMR. The cardiovascular risk from long term Prednisone is about 6x greater. The combination of chronic inflammation and Prednisone compounds the risk.

The following link concludes that the cardiovascular risk increases with higher doses and longer duration of corticosteroids but no dose is safe.
https://evidence.nihr.ac.uk/alert/low-doses-steroids-increase-cardiovascular-risks-in-inflammatory-diseases/
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If there was any consolation --- I stopped 3 blood pressure medications, a statin and warfarin over the course of the 5 years since Prednisone was stopped. I'm still being treated for PMR but not with Prednisone anymore.

Agree with the risk statistics if you are of the usual age group for PMR
talk with your doctor. If they are not knowledgeable about your risk
concerns then consider a cardiology consult. Be aware of your ESR and
CRP levels.

@dadcue
Can I ask, if you are not being treated with prednisone anymore, what are you being treated with for your PMR? Thank you.

@mimsy1

I like it when people ask me about how I'm currently being treated. It was a "stroke of luck" that Actemra (tocilizumab) was tried on January 1st, 2019.
https://www.gene.com/patients/medicines/actemra
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I will never forget the date because it was a New Year and a new beginning for me. There were some trials and tribulations from being on Prednisone daily for 12 years to treat PMR. It was either luck or divine intervention ---I'm not sure what it was but I consider it a miracle that I haven't needed any prednisone for the last 5 years.

I have multiple autoimmune conditions so not PMR alone. My rheumatologist describes it as a "full range of rheumatology problems" which started decades ago.

New diagnosis. I don’t want to be on prednisone at all. The side effects will not work for me.
Not sure what will happen.

@ggarrepy You could try Kevzara or methotrexate. They both can take up to 3 months to take full effect, but you would get some benefit before then.

BTW I had serious liver problems from one of the alternative PMR medications. It is a risk but rarely do people react as I did. That is why I went back on prednisone.

@wynclute

I had liver problems when methotrexate was tried. My rheumatologist has been monitoring my liver enzymes more closely since Actemra was started. I was referred to a liver specialist who determined that prednisone was the likely culprit for causing my liver disease.
https://www.healthline.com/health/prednisone-and-fatty-liver-disease
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Many medications affect the liver.
https://www.medicalnewstoday.com/articles/what-drugs-cause-liver-damage.
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For medications in general it is quite literally "pick your poison."