World Heart Day 2021: Why steroids are linked to higher heart disease risk

In today’s day and age, use of steroids is very common. However, one must remember that using it is not harmless. For years now it has been said that steroids cause damage to the kidneys and liver. We must note that taking high doses of steroids can also increase the risk of heart disease which includes heart attack, heart failure, and stroke.Steroids are known to fight inflammation and are often prescribed for various conditions including asthma, inflammatory bowel disease, and also arthritis. However, there are well-known adverse effects of steroids that come in the form of anti-inflammatory medications. They increase the risk of developing high blood pressure, diabetes and obesity which are all risk factors of heart disease.Below are some of the cardiovascular events that patients can experience when they consume steroids:

• Heart attack
• Heart failure
• Atrial Fibrillation (irregular and often rapid heart rhythm)
• Peripheral arterial disease (this is a circulatory condition in which blood vessels are narrowed and they reduce blood flow to the limbs)
• Stroke
• Abdominal aortic aneurysm (involves enlargement of the aorta which is the main blood vessel which delivers blood to the body)

Many a time transplant recipients take steroids to prevent organ or tissue rejection. Short-term use of steroids helps patients with allergic conditions, asthma, and COPD flare-ups. They may further help in regulating metabolic, immune and inflammatory processes in the body.For patients who are in need of long-term steroid use, it is advised to have a discussion with a medical professional around this. The conversation can include talking about the risks and benefits of steroids. It is also important for the patient to monitor their body's response to the steroid.Long-term steroids may be is associated with the risk of gaining weight leading to obesity, diabetes, high blood pressure, cholesterol issues and heart attacks. However, on the contrary for many patients steroids are required to control an autoimmune condition, a condition where the immune system attacks the body's healthy cells. Autoimmune conditions are also linked to increased risk for heart attack and stroke due to a high level of inflammation.How can a person lower the risk of cardiovascular disease?All patients who are on long-term steroids must consult their medical specialists regularly. This helps in regulating and eliminating risk factors and lowers the risk of having a heart attack. Therefore, the following lifestyle and risk factor modification strategies may be adopted by all patients:

• Regular exercise
• Change in diet – add a lot of fibres whole grains, fruits and vegetables. Also, consume food that is low in processed sugar saturated fat and salt
• One must routinely monitor blood pressure, blood sugar and lipids
• If you smoke, quit immediately

However, when one is prescribed a steroid, it is best to speak to the medical professional about adopting an alternative instead. Alternatives may include biological response modifying drugs that target the immune system's inflammatory response.The author is Director, Interventional Cardiology Fortis escorts heart institute Okhla New Delhi.