Does albuterol increase heart rate
Pro Research Analysisby 
Searched over 200M research papers
The Impact of Albuterol on Heart Rate: A Comprehensive Review
Introduction to Albuterol and Heart Rate
Albuterol, a commonly used bronchodilator, is often prescribed to manage conditions such as asthma and chronic obstructive pulmonary disease (COPD). While effective in improving respiratory function, there is ongoing concern about its potential to increase heart rate, a side effect that could pose risks, especially in patients with pre-existing cardiac conditions.
Albuterol and Heart Rate in Intensive Care Patients
Research has shown that albuterol can cause changes in heart rate among intensive care patients. A study involving 20 intensive care patients, both with and without baseline tachycardia, found that nebulized albuterol led to a mean heart rate increase of 4.4 beats per minute (6.7%) in patients without baseline tachycardia, which was statistically significant (p = 0.04) . However, in patients with baseline tachycardia, the increase was minimal and not significant .
High-Dose Albuterol and Cardiac Effects in Asthmatics
In adult asthmatics treated with high-dose continuously aerosolized albuterol, significant heart rate increases were observed. One study reported a mean heart rate increase of 16.3% across treatments, with one patient developing supraventricular tachycardia, which subsided upon discontinuation of albuterol . This suggests that high serum levels of albuterol can lead to marked cardiac stimulation.
Comparison with Other Beta-Agonists
When comparing albuterol with fenoterol, another beta-agonist, albuterol was found to have lesser maximum cardiac effects. Although both drugs increased heart rate, the increase was not significantly different between the two (Emax, 44.9 vs 32.5 beats/min; p=0.19) . This indicates that albuterol, as a partial agonist, may be safer in terms of cardiac side effects compared to full agonists like fenoterol.
Pediatric Cardiology Patients
In pediatric patients with congenital heart disease (CHD), cardiomyopathy, or supraventricular tachycardia, both racemic albuterol and levalbuterol were associated with increased heart rates. The mean increase was 6.8 beats per minute for racemic albuterol and 6.2 beats per minute for levalbuterol, with no significant difference between the two (p = 0.01) . This suggests that both forms of albuterol can increase heart rate in pediatric cardiology patients.
Critically Ill Adult Patients
In critically ill adult patients, nebulized albuterol did not cause significant tachycardia or tachyarrhythmias. A study involving 70 patients found minimal changes in heart rate after albuterol treatment, and the substitution of levalbuterol did not significantly reduce these effects . This indicates that albuterol is relatively safe in terms of heart rate changes in critically ill patients.
Effects on Athletes and Non-Asthmatics
In non-asthmatic athletes, acute inhalation of albuterol at twice the recommended dosage resulted in a significant increase in heart rate during submaximal exercise workloads . However, this increase did not translate into improved endurance performance, suggesting that while albuterol can elevate heart rate, it does not enhance athletic performance.
High-Dose Albuterol in Chronic Airflow Limitation
For patients with severe chronic airflow limitation, higher doses of inhaled albuterol were associated with dose-related increases in heart rate and other side effects such as tremor and supraventricular ectopic beats . This highlights the need to balance the bronchodilatory benefits of albuterol with its potential cardiac risks.
Conclusion
Overall, albuterol can increase heart rate, particularly at higher doses or with continuous use. While the increases are generally modest and clinically manageable, they can be significant in certain populations, such as those with pre-existing cardiac conditions or when used in high doses. Clinicians should carefully monitor heart rate in patients receiving albuterol, especially in those with underlying heart disease or when high doses are required.
Sources and full results
Most relevant research papers on this topic