SHORT-TERM CARDIOVASCULAR EFFECTS OF SALMETEROL

The occurrence of cardiovascular side effects is sometimes associated with the utilization of beta-adrenoceptor agonists, The most important causes of these undesirable pharmacologic actions are as follows: (1) direct stimulation of cardiac beta-adrenoceptors; (2) reflex activati on of adrenergic mechanisms due to peripheral vasodilation; (3) hypoka lemia; and (4) hypoxemia. The aim of this study was to evaluate the po tential short-term, cardiovascular side effects of salmeterol, a long- acting and highly selective beta(2)-adrenoceptor agonist, Eight volunt eer healthy subjects and eight patients with reversible airway obstruc tion and without cardiovascular alterations were treated with 50 mu g of salmeterol mice a day for 3 days and then with 100 mu g of salmeter ol twice a day for a further 3-day period. The 24-h ECG (Molter) monit oring and measurement of arterial BP, performed on the admission day a nd on the third and the sixth day of pharmacologic treatment, showed t hat salmeterol did not produce any significant change in mean heart ra te, number of supraventricular and ventricular premature complexes, an d BP, Furthermore, no ECG abnormality related to myocardial ischemia w as recorded during 24-h Holter monitoring. These data suggest that sal meterol, administered in regular and high doses for a short period, do es not cause significant cardiovascular effects in both normal subject s and patients with reversible airway obstruction.