Excessive Rescue Inhaler Use Associated With Higher Cardiovascular Disease Risk

By
Debbie Bunch
November 3, 2026

American Association For Respiratory Care

Objective:

To assess associations between short-acting bronchodilator (SABD) use and cardiovascular outcomes and mortality among Belgian patients with asthma or COPD.

Approach:

Study population: Researchers analyzed a nationwide Belgian cohort of 226,314 patients with asthma and 57,446 with COPD.
Exposure and comparison: Outcomes were compared by use of SABA, SAMA, or combined SABA+SAMA canisters during the baseline year, including 1–2 or at least 3 canisters, versus no use.

Key Findings:

About 17% of patients with asthma and 30% with COPD used at least 3 SABD canisters during baseline.
Among patients with asthma and COPD, SAMA and SABA+SAMA use was associated with 1.2–1.4-fold higher heart failure risk, 1.1–1.4-fold higher arrhythmia risk, and 1.1–1.7-fold higher all-cause mortality risk.
In asthma, use of 1–2 or at least 3 SABA+SAMA canisters was associated with 1.2–1.4-fold higher myocardial infarction risk and 1.2–1.3-fold higher ischemic stroke risk.
In COPD, use of at least 3 SABA+SAMA canisters was associated with 1.4-fold higher myocardial infarction risk.

Interpretation:

The authors reported associations between greater use of some short-acting bronchodilators and cardiovascular outcomes and all-cause mortality.

Limitations:

The provided article context does not describe study design details beyond the nationwide cohort analysis.
The context does not report confidence intervals, adjustment methods, or other limitations.

Conclusion:

The authors believe short-acting bronchodilator use should be monitored in people with asthma or COPD, including those without identified cardiovascular disease.