Beta-Agonist Therapy Increases Risk Of Heart Attack
In Patients With Cardiovascular Disease

	April 28, 1999 - Use of beta-agonist 
inhalers increase the risk of heart attack by more 
than 3 times in patients with a history of heart 
disease, according to the results of from Washington
State. Dr. Au and colleagues reviewed the records of
1,444 patients hospitalized for a first heart attack
and 4,000 matched controls. Patients who had 
received one beta-agonist inhaler during the 3 months
before hospitalization were 67% more likely to have a
first heart attack.
	Excess risk was confined to patients who had 
a history of cardiovascular disease. Dr. Au said that
beta-agonists may actually increase the risk of heart
attack or they might be "innocent," in that they are 
prescribed for nonspecific chest discomfort, which 
could actually be angina.
	"Physicians should use caution when prescribing
beta-agonists for the first time in patients with 
cardiovascular disease," according to Dr. Au. However,
he stressed that beta-agonists remain first-line 
therapy for airflow limitation caused by asthma and 
COPD.
	Dr. Au recommends that doctors consider other
diagnoses, such as angina, in patients who have a 
history of heart disease or several cardiovascular risk
factors and present with symptoms of airway inflammation,
particularly if symptoms do not get better with inhaler
therapy.