Overuse of Rescue Inhalers Linked to Increased Risk for Cardiovascular Diseases

By Debbie Bunch

November 3, 2026 | 2 min read

Overuse of rescue inhalers is generally a red flag for clinicians, suggesting their patients may not be on the right controller inhalers or may not be using them correctly.

Now European researchers are suggesting that it may be linked to a greater risk for cardiovascular conditions like heart attack and stroke as well.

The study was conducted among 226,314 asthma patients and 57,446 COPD patients in Belgium and compared outcomes among those who did not use short-acting beta₂-agonists (SABA), short-acting muscarinic antagonists (SAMA), or SABA+SAMA, and those who did. The authors found:

Compared with no use, SAMA and SABA+SAMA use, defined as using 1-2 and ≥3 canisters in the baseline year, was associated with a 1.2-1.4-fold increased risk in heart failure, a 1.1-1.4-fold increased risk in arrhythmia, and a 1.1-1.7-fold increased risk in mortality in both asthma and COPD patients.
Among asthma patients, use of 1-2 and ≥3 SABA+SAMA canisters per year was additionally associated with a 1.2-1.4-fold increased risk in myocardial infarction and 1.2-1.3-fold increased risk in ischemic stroke risk.
Using ≥3 SABA+SAMA cannisters per year was associated with a 1.4-fold increased risk in myocardial infarction in COPD patients.
Compared to patients who did not use SABA, using ≥3 SABA canisters per year was associated with a 1.1-fold increased risk in heart failure and mortality in asthma and COPD patients, but no increased risks were observed for those who used 1-2 SABA canisters per year.

The authors believe these findings highlight the importance of monitoring short-acting bronchodilator (SABD) use in patients with asthma and COPD, including those without known cardiovascular conditions.

“In this Belgian nationwide cohort study of patients with asthma and COPD, we found that around 17% of asthma patients used ≥3 SABD canisters (SABD overuse) in the baseline period and 30% of COPD patients had SABD overuse,” they wrote. “Increasing the number of SAMA and fixed-dose SABA+SAMA combination canisters was associated with a higher risk of cardiovascular outcomes and all-cause mortality.

The study was published by Thorax.

Highlighted in RC Buzz, November 9, 2026

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Debbie Bunch

Debbie Bunch has a bachelor's degree in journalism from the University of North Texas and lives in Dallas, Texas. She has spent many years writing for the AARC on topics ranging from clinical innovations to management. In her spare time, she enjoys traveling, reading, photography, and spending time with friends, family, and her rescue pup Juju.

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