Beta-blockers cut risk of CVD in COPD by 40%

Beta-blockers can cut the risk of death from cardiovascular disease (CVD) by 40 per cent in patients with COPD without hindering lung function, US research suggests.

CVD is the leading cause of death in patients with COPD, with coronary artery disease present in 10-22 per cent of COPD patients.

But the use of beta-blockers is not always advocated in COPD patients because of concerns about adverse effects of beta-blockade on airway function.

NICE guidance on COPD management, issued in February 2004, does not make any recommendations for beta-blocker use.

For this latest study the researchers identified 825 patients, when 142 were on beta-blockers, admitted to hospital with acute exacerbations of COPD between October 1999 and September 2006.

Patients with asthma were excluded from the study. During the seven-year study, 43 patients died from CVD.

When the mortality rate of those who received beta-blockers and those who did not were compared, beta-blocker use had reduced CVD mortality by 40 per cent.

But in a subset of patients with available spirometric data, no real difference in lung function was found between those who received beta-blockers and those who did not.

Lead researcher Dr Mark Dransfield, medical director of the lung health centre at the University of Alabama, said: 'The results suggest beta-blockers are not harmful in patients with COPD. 'In combination with previous reports, this study supports planning randomised trials in the outpatient setting.'

Such randomised clinical trials are required to confirm the safety of beta-blocker use in COPD patients, added Dr Dransfield.

Professor David Price, professor of respiratory medicine at the University of Aberdeen and a member of General Practice Airways Group (GPIAG), said the study findings were 'safe.'

'The current guidance about using beta-blockers in COPD patients is inconsistent,' he said.

'During exacerbations COPD patients are at a greater risk of CVD, so using beta-blockers would be a good option.'

This research highlights the importance of treating the co-morbidities of COPD and not just the disease itself, he said.

'It is estimated that 20-30 per cent of people with cardiovascular risk factors will have COPD.'

But beta-blockers should only be used in patients with COPD and not in any patients that have asthma, said Professor Price.

sanjay.tanday@haymarket.com

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Beta-blockers
Beta-blockers cut CVD mortality risk by 40% in COPD patients
Source: Thorax Online.

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