β-Blockers Might Improve COPD Outcomes

June 26, 2019 by Dr. Clemens Leave a Comment

Authors: Nielsen AO et al.

EClinicalMedicine 2019 Jan

Hospitalizations for chronic obstructive pulmonary disease were less common in patients who received β-blockers.

Patients with chronic obstructive pulmonary disease (COPD) often do not receive β-blockers because of concerns that they might exacerbate respiratory symptoms. Using Danish registries from 1995 to 2015, investigators studied the incidence of COPD hospitalizations among 300,000 new users of β-blockers and among 1 million new users of other antihypertensive agents; patients with histories of COPD were excluded.

Compared with patients who received other antihypertensive agents, patients who received β-blockers had significantly lower adjusted risks for COPD hospitalization (6.5 vs. 9.2 cases/1000 person-years; adjusted hazard ratio, 0.8) and all-cause mortality (1.8 vs. 3.1 deaths/1000 person-years; aHR, 0.6). Outcomes remained robust in various subgroup analyses, including subgroups that used β₁-selective β-blockers versus nonselective β-blockers.

COMMENT

These researchers did not examine associations between new β-blocker use and outcomes in patients with already diagnosed COPD. Rather they showed that, compared with nonusers of β-blockers, β-blocker users who subsequently received diagnoses of COPD didn’t have worse outcomes; indeed, outcomes were better in the β-blocker cohort. Previous trials have shown that cardioselective β-blockers are safe in patients with stable COPD and might improve outcomes in COPD patients who start them for valid cardiovascular indications (NEJM JW Hosp Med Aug 2010 and JAMA Intern Med 2010; 170:880).

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