Med. praxi. 2015;12(3):130-134

Doubts about beta-blockers: Chronic obstructive lung disease and asthma

MUDr.Michal Prokeš, PharmDr.Josef Suchopár
INFOPHARM a.s., Praha

The incidence of and mortality from chronic obstructive pulmonary disease (COPD) and cardiovascular disease is high in developed countries.

Coronary artery disease is a compelling indication for beta-blockers use in a patient population in whom beta-receptor antagonism

is often considered as contraindication. Beta-blockers provide COPD patients with established benefits in the treatment of heart failure

and they prolong life after acute myocardial infarction. Cardioselective beta-blockers could save lives and improve quality of life also in

appropriately selected asthma bronchiale patients with cardiovascular disease. Because the risk of bronchospasm with cardioselective

agents is not completely eliminated, care must be exercised in choosing the appropriate patient and in applying the approriate safety

measures. This review brings the avilable evidence of beta-blockers´ effects, safety and risks, when treating asthma and CHOPN patients

with cardiovascular disease, which is important for physician´s decisions in therapeutic praxis.

Keywords: beta-blockers, chronic obstructive pulmonary disease, asthma bronchiale, cardiovascular disease

Published: June 24, 2015  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
Prokeš M, Suchopár J. Doubts about beta-blockers: Chronic obstructive lung disease and asthma. Med. praxi. 2015;12(3):130-134.
Share...
Download citation
  • BibTeX (.bib)
  • Bookends (.ris)
  • EasyBib (.ris)
  • EndNote (.enw)
  • EndNote 8 (.xml)
  • ISI WoS (.isi)
  • Medlars (.medlars)
  • Mendeley (.ris)
  • MODS (.xml)
  • Papers (.ris)
  • RefWorks (.txt)
  • RefManager (.ris)
  • RIS (.ris)
  • MS Word (.xml)
  • Zotero (.ris)
    • Open full article

    References

    1. Albouaini K, Andron M, Alahmar A, et al. Beta-blockers use in patients with chronic obstructive pulmonary disease and concomitant cardiovascular conditions. Int J Chrn Obstruct Pulmon Dis 2007; 2: 335-340.
    2. Chen J, Radford MJ, Wang Y, et al. Effectiveness of beta-blocker therapy after acute myocardial infarction in elderly patients with chronic obstructive pulmonary disease or asthma. J Am Cardiol 2001; 37: 1950-1956. Go to original source... Go to PubMed...
    3. Egred M, Shaw S, Mohammad B, et al. Under-use of beta-blockers in patients with ischaemic heart disease and concomitant chronic obstructive pulmonary disease. Q J Med 2005; 98: 493-497. Go to original source... Go to PubMed...
    4. Stephan MS, Bannuru RR, Lessard D, et al. The impact of COPD on management and outcomes of patients hospitalized with acute myocardial infarction. A 10-year retrospective observational study. CHEST 2012; 141: 1441-1448. Go to original source... Go to PubMed...
    5. Prokeš M, Suchopár J. Otazníky kolem beta-blokátorů: diabetes mellitus, hypoglykémie a dyslipidémií. Medicína po promoci 2015; v tisku.
    6. Williams IP, Millard FJC. Severe asthma after inadvertent ingestion of oxprenolol. Thorax 1980; 35: 160. Go to original source... Go to PubMed...
    7. Raine JM, Palazzo MG, Kerr JH, Sleight P. Near-fatal bronchosmasm after oral nandolol in a young asthmatic and response to ventilation with halothane. Br Med J 1981; 282: 548-549. Go to original source... Go to PubMed...
    8. Harries AD. Beta-blockade in asthma. Br Med J 1981; 282: 1321. Go to original source... Go to PubMed...
    9. Nelson WL, Fraunfelder FT, Sills JM, et al. Adverse respiratory and cardiovascular events attributed to timolol ophtalmic solution, 1978-1985. Am J Ophtalmol 1986; 102: 606-511. Go to original source... Go to PubMed...
    10. Odeh M, Oliven A, Bassan H. J Fam Pract 1991; 32: 97-98.
    11. Formgren H. The effect of metoprolol and practolol on lung function and blood pressure in hypertensive asthmatics. Br J Clin Pharmacol 1976; 3: 1007-1014. Go to original source... Go to PubMed...
    12. Krauss S, Spitz E, Krauss A, et al. Treatment of hypertension in mild asthmatic patients with atenolol. Angiology 1984; 35: 773-778. Go to original source... Go to PubMed...
    13. Van Zyl, Jennings AA, Bateman ED, Opie LH. Comparison of respirátory effects of two cardioselective beta-blockers, celiprolol and atenolol, in asthmatics with mild to moderate hypertension. Chest, 1989; 95: 209-213. Go to original source... Go to PubMed...
    14. Kotlyar E, Keogh AM, Macdonald PS, et al. Tolerability of carvedilol in patients with heart failure and doncomitant chronic obstructive pulmonary disease or asthma. J Heart Lung Transpant 2002; 21: 1290-1295. Go to original source... Go to PubMed...
    15. Shaw SM, Hasleton J, Williams SG. ?-blocker use in heart failure patients with airways disease. Clin Cardiol 2009; 32: 393-396. Go to original source... Go to PubMed...
    16. Gottlieb SS, McCarter RJ, Vogel RA. Effect of beta-blockade on mortality among high-risk and low-risk patients after yocardial infarction. N Engl J Med 1998; 339: 489-497. Go to original source... Go to PubMed...
    17. Quint JK, Herrett E, Bhaskaran K, et al. Effect of ?-blockers on mortality after myocardial infarction in adults with COPD: population based cohort study of UK electronic healthcare records. Br Med J 2013; 347: f6650. doi: 10.1136/bmj.f6650,http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3898388/pdf/bmj.f6650.pdf. Go to original source... Go to PubMed...
    18. Au DH, Bryson SL, Fan VS, et al. Bete-blockers as single-agent therapy for hypertension and the risk of mortality among patients with chronic obstructive pulmonary disease. Am J Med 2004; 117: 925-931. Go to original source... Go to PubMed...
    19. Camsari A, Arikan S, Avan C, et al. Metoprolol, a beta-1 selective blocker, can be used safely in coronary artery disease patients with chronic obstructive pulmonary disease. Heart Vessels 2003; 18: 188-192. Go to original source... Go to PubMed...
    20. Hawkins NM, MacDonald MR, Petrie MC, et al. Bisoprolol in patients with heart failure and moderate to severe chronic obstructive pulmonary disease: a randomized controlled trial. Eur J Heart Fail 2009; 11: 684-690. Go to original source... Go to PubMed...
    21. Jabbour A, Macdonald PS, Keogh AM, et al. Diferences between beta-blockers in patients with chronic heart failure and chronic obstructive pulmonary disease: a ransomised crossover trial. J Am Coll Cardiol 2010; 55: 1780-1787. Go to original source... Go to PubMed...
    22. Lainscak M, Podbregar M, Kovacic D, et al. Differences between bisoprolol and carvedilol in patients with chronic heart failure and chronic obstructive pulmonary disease: a randomized trial. Respir Med 2011; 105(Suppl 1): S44-49. Go to original source... Go to PubMed...
    23. Critchley WR, Al-Sheklly B, Sekar B, et al. Specialist initiation and monitoring of beta blockers in patients with chronic heart failure and concomitant obstructive airways disease. Int J Cardiol 2013; 167(5): 2361-2363. Go to original source... Go to PubMed...
    24. Špinar J, Vítovec J, Hradec J, et al. Doporučený postup České kardiologické společnosti pro diagnostiku a léčbu chronického srdečního selhání, 2011. Cor Vasa 2011. DOI: 10.1016/j.crvasa.2012.03.002, http://www.kardio-cz.cz/resources/upload/data/475_161-182.pdf.
    25. Želízko M, Toušek F, Skalická H. Souhrn doporučených postupů ESC pro diagnostiku a léčbu stabilní ischemické choroby srdeční - 2013. Připraven Českou kardiologickou společností. Cor Vasa 2014.DOI: 10.1016/j.crvasa.2014.02.006 http://www.kardio-cz.cz/resources/upload/data/663_313-328.pdf.
    26. Hradec J, Bultas J, Želízko M. Stabilní angina pectoris. Doporučený diagnostický a léčebný postup České kardiologické společnosti. Cor Vasa 2010; 52(9): 543-561. Go to original source...
    27. Filipovský J, Widimský jr. J, Ceral J, et al. Diagnostické a léčebné postupy u arteriální hypertenze - verze 2012. Doporučení České společnosti pro hypertenzi. http://www.prolekare.cz/pdf?id=39033.
    28. Koblížek V, Chlumský J, Zindr V, et al. Doporučený postup ČPFS pro diagnostiku a léčbu stabilní CHOPN
    29. http://www.pneumologie.cz/guidelines/, vstup únor 2015.
    30. Česká pneumologická a ftizeologická společnost ČLS JEP: Doporučený postup diagnostiky a léčby astmatu České pneumologické a ftizeologické společnosti ČLS JEP. http://www.pneumologie.cz/guidelines/, vstup únor 2015.
    31. Doporučený postup Global Iniciative for Asthma Management and Prevention, 2014: http://www.ginasthma.org/local/uploads/files/GINA_Report_2014_Aug12.pdf.
    32. GOLD Report 2015: http://www.goldcopd.org/uploads/users/files/GOLD_Report_2015.pdf.
    33. Databáze léků SÚKLu, http://www.sukl.cz/modules/medication/search.php.
    34. Self T, Soberman JE, Bubla JM, et al. Cardioselective beta-blockers in patients with asthma and concomitant heart failure or history of myocardial infarction: When do benefits outweigh risk? Journal of Asthma 2003; 40: 839-845. Go to original source... Go to PubMed...
    35. Self TH, Wallace JL, Soberman J. Cardioselective beta-blocker treatment of hypertension in patients with asthma: When do benefits outweigt risks? Journal of Asthma, 2012; 49: 947-951. Go to original source... Go to PubMed...

    Return to the content


    Medicine for Practice

    Madam, Sir,
    please be aware that the website on which you intend to enter, not the general public because it contains technical information about medicines, including advertisements relating to medicinal products. This information and communication professionals are solely under §2 of the Act n.40/1995 Coll. Is active persons authorized to prescribe or supply (hereinafter expert).
    Take note that if you are not an expert, you run the risk of danger to their health or the health of other persons, if you the obtained information improperly understood or interpreted, and especially advertising which may be part of this site, or whether you used it for self-diagnosis or medical treatment, whether in relation to each other in person or in relation to others.

    I declare:

    1. that I have met the above instruction
    2. I'm an expert within the meaning of the Act n.40/1995 Coll. the regulation of advertising, as amended, and I am aware of the risks that would be a person other than the expert input to these sites exhibited

    No
    Yes

    If your statement is not true, please be aware
    that brings the risk of danger to their health or the health of others.