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Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet]. Chichester, UK: John Wiley & Sons, Ltd; 2003-. doi: 10.1002/14651858.CD003566.pub2

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet].

Are cardioselective beta‐blockers a safe and effective treatment in patients with chronic obstructive pulmonary disease?

This version published: 2016; Review content assessed as up-to-date: August 18, 2010.

Link to full article: [Cochrane Library]

Plain language summary

Long term treatment with beta blocker medication reduces the risk of death in patients with high blood pressure, heart failure and coronary artery disease. But patients who have both COPD and cardiovascular disease sometimes do not receive these medicines because of fears that they may worsen the airways disease. This review of data from 22 randomised controlled trials on the use of cardioselective (heart‐specific) beta blockers in patients with COPD demonstrated no adverse effect on lung function or respiratory symptoms compared to placebo. This finding was consistent whether patients had severe chronic airways obstruction or a reversible obstructive component. In conclusion, cardioselective beta‐blockers should not be withheld from patients with COPD.

Abstract

Background: Beta blocker therapy has a proven mortality benefit in patients with hypertension, heart failure and coronary artery disease, as well as during the perioperative period. These drugs have traditionally been considered contraindicated in patients with chronic obstructive pulmonary disease (COPD).

Objectives: To assess the effect of cardioselective beta blockers on respiratory function of patients with COPD.

Search methods: A comprehensive search of the Cochrane Airways Group Specialised Register (derived from systematic searches of CENTRAL, MEDLINE, EMBASE and CINAHL) was carried out to identify randomised blinded controlled trials from 1966 to August 2010. We did not exclude trials on the basis of language.

Selection criteria: Randomised, blinded, controlled trials of single dose or longer duration that studied the effects of cardioselective beta blockers on the forced expiratory volume in one second (FEV1) or symptoms in patients with COPD.

Data collection and analysis: Two independent reviewers extracted data from the selected articles, reconciling differences by consensus. Two interventions studied were the administration of beta blocker, given either as a single dose or for longer duration, and the use of beta2‐agonist given after the study drug.

Main results: Eleven studies of single‐dose treatment and 11 of treatment for longer durations, ranging from 2 days to 16 weeks, met selection criteria. Cardioselective beta blockers, given as a single dose or for longer duration, produced no change in FEV1 or respiratory symptoms compared to placebo, and did not affect the FEV1 treatment response to beta2‐agonists. Subgroup analyses revealed no significant change in results for those participants with severe chronic airways obstruction, those with a reversible obstructive component, or those with concomitant cardiovascular disease.

Authors' conclusions: Cardioselective beta blockers, given to patients with COPD in the identified studies did not produce adverse respiratory effects. Given their demonstrated benefit in conditions such as heart failure, coronary artery disease and hypertension, cardioselective beta‐blockers should not be routinely withheld from patients with COPD.

Editorial Group: Cochrane Airways Group.

Publication status: Edited (no change to conclusions).

Citation: Salpeter SR, Ormiston TM, Salpeter EE. Cardioselective beta‐blockers for chronic obstructive pulmonary disease. Cochrane Database of Systematic Reviews 2005, Issue 4. Art. No.: CD003566. DOI: 10.1002/14651858.CD003566.pub2. Link to Cochrane Library. [PubMed: 16235327]

Copyright © 2016 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.

PMID: 16235327

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