CONTEXT: Mirabegron, the first β3-adrenoceptor agonist in clinical practice, is 
approved for treatment of overactive bladder (OAB) syndrome symptoms. Because 
β3-adrenoceptors are expressed in cardiovascular (CV) tissues, there are 
concerns that OAB treatment with β3-adrenoceptor agonists may affect the heart 
and vasculature.
OBJECTIVE: To provide a summary of CV effects of β3-adrenoceptor agonists in 
clinical studies.
EVIDENCE ACQUISITION: A systematic literature search from inception until 
November 2014 was performed on studies in PubMed and Medline.
EVIDENCE SYNTHESIS: Twenty papers, published between 1994 and 2014, were 
identified: mirabegron (16), solabegron (2), AK-677 (1), and BRL35135 (1). More 
detailed CV data from mirabegron studies were available in online regulatory 
documents filed with the US Food and Drug Administration and the UK National 
Institute for Health and Care Excellence.
CONCLUSIONS: The CV safety of mirabegron appears to be acceptable at therapeutic 
doses and comparable with that of antimuscarinic agents, currently first-line 
therapy for OAB.
PATIENT SUMMARY: In this review we looked at the cardiovascular (CV) effects of 
β3-adrenoceptor agonists used for the treatment of overactive bladder (OAB). The 
CV safety of mirabegron (the only clinically approved β3-adrenoceptor agonist) 
appears to be acceptable at therapeutic doses and comparable with that of 
antimuscarinic agents, the current first-line therapy for OAB.