Editorials

Treatment with β blockers in people with COPD

BMJ 2011; 342 doi: http://dx.doi.org/10.1136/bmj.d2655 (Published 10 May 2011) Cite this as: BMJ 2011;342:d2655
  1. Shamsah Kazani, instructor of medicine,
  2. Elliot Israel, professor of medicine
  1. 1Harvard Medical School, Brigham and Women’s Hospital, Boston, MA 02115, USA
  1. eisrael{at}partners.org

May reduce respiratory symptoms and mortality independently of cardiovascular effects

Treatment with β blockers reduces mortality associated with cardiovascular diseases. Unfortunately, doctors tend to avoid β blockers in patients who have concomitant obstructive lung disease. This stems from the fear of precipitating a catastrophic respiratory event—acute bronchospasm has been reported after administration of β blockers to patients with asthma and chronic obstructive pulmonary disease (COPD).1 2 3 4 However, evidence suggests that β blockers reduce mortality in patients with COPD, which makes sense because patients often have concomitant cardiovascular disease.5 A study of 462 patients with COPD undergoing major vascular surgery found a 27% reduction in perioperative mortality in those who were receiving cardioselective β blockers compared with those who were not.6

Surprisingly, in addition to reducing overall mortality and death from cardiovascular disease in patients with COPD, long term use of β blockers may also reduce respiratory events …

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