Beta-adrenergic drugs and risk of Parkinson's disease: A systematic review and meta-analysis

Ambrish Singh, Salman Hussain, Sreelatha Akkala, Jitka Klugarova, Andrea Pokorna, Miroslav Klugar, E. Haydn Walters, Ingrid Hopper, Julie A. Campbell, Bruce Taylor, Benny Antony

Research output: Contribution to journalReview ArticleResearchpeer-review

6 Citations (Scopus)


Background: Parkinson's Disease (PD) is a neurodegenerative disorder manifested by rest tremor, rigidity, bradykinesia, and postural instability. Recent pharmaco-epidemiological studies evaluating beta-adrenergic drug use and risk of PD have reported conflicting findings. Objectives: This systematic review and meta-analyses evaluate the association between beta-adrenergic (agonists and antagonists) drugs’ use and PD. Methods: An electronic literature search of eight databases was performed from inception to July 2021 to identify pharmaco-epidemiological studies (case-control and cohort) reporting the risk of PD in beta-adrenergic users compared to non-users. We used the generic inverse variance method and RevMan (5.3.5) to estimate pooled adjusted risk ratios (aRRs) of PD using a random-effects model. Results: Of 3168 records, 15 studies (10 case-control; five cohort) with 6508,877 participants, including 87,011 PD cases, were included. In the pooled analysis (n = 10) including any beta-antagonist users, compared with non-users, the aRR for PD was 1.19 (CI: 1.05,1.35); for any beta-agonist users (n = 8) aRR for PD was 0.87 (CI: 0.78,0.97). Propranolol users had a significantly increased risk of PD (aRR:1.91; CI:1.20,3.06), whereas salbutamol use was associated with reduced risk of PD (aRR:0.95; CI:0.92,0.99). Significant heterogeneity (I2 >87%) was observed, but the majority (n = 13) of the studies were of high quality, based on the JBI tool. Conclusions: Beta-antagonist use was associated with a modestly increased risk of PD, whereas beta-agonist use was associated with a modest decreased risk of PD. Future epidemiological studies should address the issues of protopathic bias and indirect association using appropriate epidemiological methods.

Original languageEnglish
Article number101670
Number of pages13
JournalAgeing Research Reviews
Publication statusPublished - Sept 2022


  • Beta-adrenoceptors
  • Beta-agonist
  • Beta-antagonist
  • Beta-blockers
  • Parkinson's disease
  • Propranolol
  • Salbutamol

Cite this