Beta-blockers and the management of COPD

January 01, 0001

Beta-blockers and the management of COPD

Beta-agonists are a mainstay of therapy for chronic obstructive pulmonary disease (COPD). These Scottish researchers looked at the effect of beta-blockers when added to patients with of COPD. They performed a retrospective cohort study with a database of COPD patients in Scotland (TARDIS) along with records of medication use, hospitalization, and mortality. They enrolled patients >50 years of age with COPD (n=5977). Main outcome measures Hazard ratios were calculated using Cox proportional hazard regressions. Eighty-eight percent of â blocker used in the study were cardioselective.

The researchers found: "There was a 22% overall reduction in all cause mortality with beta-blocker use. Furthermore, there were additive benefits of beta-blockers on all cause mortality at all treatment steps for COPD. Compared with controls (given only inhaled therapy with either short acting beta-agonists or short acting antimuscarinics), the adjusted hazard ratio for all cause mortality was 0.28 for treatment with inhaled corticosteroid, long acting beta-agonist, and long acting antimuscarinic plus â blocker versus 0.43 without beta-blocker. There were similar trends showing additive benefits of beta-blockers in reducing oral corticosteroid use and hospital admissions due to respiratory disease. Beta-blockers had no deleterious impact on lung function at all treatment steps when given in conjunction with either a long acting beta-agonist or antimuscarinic agent"

The researchers concluded: "Beta-blockers may reduce mortality and COPD exacerbations when added to established inhaled stepwise therapy for COPD, independently of overt cardiovascular disease and cardiac drugs, and without adverse effects on pulmonary function."

This study finds evidence that beta-blockers are actually beneficial in patients with COPD

For the full abstract, click here.

BMJ 342:d2549, 10 May 2011
© 2011 BMJ Publishing Group Ltd.
Effect of beta-blockers in treatment of chronic obstructive pulmonary disease: a retrospective cohort study. Philip M Short, Samuel I W Lipworth, Douglas H J Elder, Stuart Schembri, Brian J Lipworth. Correspondence to B J Lipworth:

Category: R. Respiratory. Keywords: beta-blockers, COPD, beta-agonists, mortality, exacerbations, restrospective cohort study, journal watch.
Synopsis edited by Dr Paul Schaefer, Toledo, Ohio. Posted on Global Family Doctor 3 June 2011

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