JMIR Publications

ABSTRACT

Background:

Beta-2 agonists play an important role in the management of asthma. Inhaled Long-Acting Beta-2 Agonists (LABAs) and Short-Acting Beta-2 Agonists (SABAs) cause bronchodilation by stimulating adrenoceptors. These receptors are also present on cardiac cells and, as a side-effect, could also be stimulated by inhaled beta-2 agonists.

Objective:

In this study we assessed the effect of Beta-2 agonists on the heart rate (HR).

Methods:

We retrieved data from an observational study, the myAirCoach Quantification Campaign. Beta-2 agonist use was registered by self-reported monthly questionnaires and by smartinhalers. HR was monitored continuously with the Fitbit Charge HR tracker. Patients (age ≥ 18) were recruited if they had uncontrolled asthma and used inhalation medication. Our primary outcome was the difference in HR between LABA and non-LABA users. Secondary outcomes were the difference in HR on days SABAs were used compared to days SABAs were not used and an assessment of the timing of inhaler usage during the day.

Results:

Patients using LABA did not have a clinically relevant higher HR (average 0.8 bpm difference) during the day. Around the moment of SABA inhalation itself the HR does increase steeply and it takes 138 minutes before it returns to the normal range.

Conclusions:

This study indicates that long-acting beta-2 agonists do not have a clinically relevant effect on heart rate. Short-acting beta-agonist are instead associated with a short-term HR increase.