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MeReC Extra 37

The National Prescribing Centre (NPC) has published MeReC Extra 37 (PDF).

This MeReC discusses recent concerns regarding the cardiovascular safety of anticholinergics in chronic obstructive pulmonary disease (COPD). These concerns were raised in a recent meta-analysis however the data are not conclusive and more work is required. The article recommends discussing the risks and benefits of treatment with patients and provides numerical data for heart attacks in comparison to reductions in exacerbations and hospital admissions.

This publication also discusses recent research that indicated a lack of benefit for aspirin in primary prevention of cardiovascular events in patients with diabetes. The study in question was too small to definitively rule out a benefit for aspirin however it is still important to manage cardiovascular risk factors in people with diabetes mellitus including smoking cessation, blood pressure management and treatment with a statin.

Action: Clinicians who see patients with COPD or diabetes will find this information useful and informative.