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ABSTRACT
Introduction: The use of beta-blockers in chronic obstructive pulmonary disease (COPD) is controversial, primarily due to concerns that they may worsen lung function and attenuate bronchodilator response.
Areas covered: This review summarizes the reasons for and against the use of beta-blockers in COPD by evaluating the literature on the effects of these drugs on lung function, exacerbation rate, and mortality. The safety of beta-blockers in COPD patients with concomitant heart failure, an entity that is not always distinguishable from COPD exacerbations, is also explored.
Expert commentary: The use of cardioselective beta-blockers appears safe in the management of cardiac comorbidities associated with COPD and may lower exacerbation and mortality risk. There is a growing body of evidence demonstrating the safety of beta-blockers in patients with acute heart failure, acute respiratory failure or sepsis, entities that could occur simultaneously with COPD exacerbations. However, randomized controlled trials are still lacking to confirm these results.
Declaration of interest
FSL Filho gratefully acknowledges postdoctoral support from the Canadian Institutes of Health Research (CIHR) Integrated and Mentored Pulmonary and Cardiovascular Training program (IMPACT). DD Sin is a Tier 1 Canada Research Chair and is supported by the Canadian Institutes of Health Research, Genome Canada, and the Canadian Respiratory Research Network (CRRN). The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.