Beta-blocker treatment for cardiac disease not too adverse for COPD

January 01, 0001

Beta-blocker treatment for cardiac disease not too adverse for COPD

Globally, cardiovascular disease (CVD) is the leading cause of death. Beta-blocker medications have well- established survival benefit for myocardial infarction and heart failure. However, CVD frequently coexists with chronic obstructive airways disease (COPD), a disease in which beta- blockers are traditionally avoided. The researchers from Australia sought to investigate the adverse respiratory effects associated with long term beta-blocker treatment in patients with cardiac disease, and presumed high risk of COPD. In this prospective cohort study, patients admitted with acute cardiac disease were recruited from the cardiology unit of a tertiary referral hospital. The treating cardiologist determined beta- blocker treatment, independent of the study. Sixty-four subjects participated, 30 of whom received beta- blockers.

Beta-blockers did not adversely affect spirometry, respiratory symptoms or survival. However, considering two categories of respiratory exacerbations (symptom-based versus treated) subjects taking beta-blockers accumulated increased annual risk (RR 1.30 and RR 1.37) and concluded with overall increased risk (RR 3.67 and RR 4.03), when compared with the group not taking beta-blockers.

The researchers concluded: "Long term beta-blocker treatment did not adversely affect lung function, respiratory symptom scores or survival, but was associated with increased risk of respiratory exacerbations."

Overall, if the beta blockers were required for cardiac reasons, they ‘weren’t too bad’ for COPD patients.

For the full abstract, click here.

Internal Medicine Journal published online 25 July 2011 © 2011 Royal Australasian College of Physicians
Investigating the adverse respiratory effects of beta-blocker treatment: six years of prospective longitudinal data in a cohort with cardiac disease. Belinda Cochrane, Steve Quinn, Haydn Walters and Iven Young. Correspondence to Belinda Cochrane: [email protected]

Category: K. Circulatory, R. Respiratory. Keywords: beta-blockers, adrenergic, heart disease, undesirable effects, disease exacerbation, COPD, prospective cohort study, journal watch.
Synopsis edited by Dr Stephen Wilkinson, Melbourne, Australia. Posted on Global Family Doctor 12 August 2011

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.