 |
|
β-Blockers May Reduce Mortality and Risk of Exacerbations in Patients With Chronic Obstructive Pulmonary Disease
Frans H. Rutten, MD, PhD;
Nicolaas P. A. Zuithoff, MSc;
Eelko Hak, MSc, PhD;
Diederick E. Grobbee, MD, PhD;
Arno W. Hoes, MD, PhD
Arch Intern Med. 2010;170(10):880-887.
Background Physicians avoid the use of β-blockers in patients with chronic obstructive pulmonary disease (COPD) and concurrent cardiovascular disease because of concerns about adverse pulmonary effects. We assessed the long-term effect of β-blocker use on survival and exacerbations in patients with COPD.
Methods An observational cohort study using data from the electronic medical records of 23 general practices in the Netherlands. The data included standardized information about daily patient contacts, diagnoses, and drug prescriptions.
Results In total, the study included 2230 patients 45 years and older with an incident or prevalent diagnosis of COPD between 1996 and 2006. The mean (SD) age of the patients with COPD was 64.8 (11.2) years at the start of the study, and 53% of the patients were male. During a mean (SD) follow-up of 7.2 (2.8) years, 686 patients (30.8%) died and 1055 (47.3%) had at least 1 exacerbation of COPD. The crude and adjusted hazard ratios with Cox regression analysis of β-blocker use for mortality were 0.70 (95% confidence interval [CI], 0.59-0.84) and 0.68 (95% CI, 0.56-0.83), respectively. The crude and adjusted hazard ratios for exacerbation of COPD were 0.73 (95% CI, 0.63-0.83) and 0.71 (95% CI, 0.60-0.83), respectively. The adjusted hazard ratios with the propensity score methods were even lower. Subgroup analyses revealed that patients with COPD but without overt cardiovascular disease had similar results.
Conclusion Treatment with β-blockers may reduce the risk of exacerbations and improve survival in patients with COPD, possibly as a result of dual cardiopulmonary protective properties.
Author Affiliations: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht (Drs Rutten, Hak, Grobbee, and Hoes and Mr Zuithoff), and Department of Epidemiology, University Medical Center Groningen, Groningen (Dr Hak), the Netherlands.
 CiteULike  Connotea  Delicious  Digg  Facebook  Reddit  Technorati  Twitter
What's this?
RELATED ARTICLES
A Curious Case of β-Blockers in Chronic Obstructive Pulmonary Disease
Don D. Sin and S. F. Paul Man
Arch Intern Med. 2010;170(10):849-850.
EXTRACT
| FULL TEXT
β-Blockers for Chest Pain Associated With Recent Cocaine Use
Carlos Rangel, Richard G. Shu, Lawrence D. Lazar, Eric Vittinghoff, Priscilla Y. Hsue, and Gregory M. Marcus
Arch Intern Med. 2010;170(10):874-879.
ABSTRACT
| FULL TEXT
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
{beta}-blockers associated with reduced all-cause mortality in COPD
Tashkin
Evid. Based Med. 2012;17:31-32.
FULL TEXT
Distinct patterns of inflammation in the airway lumen and bronchial mucosa of children with cystic fibrosis
Regamey et al.
Thorax 2012;67:164-170.
ABSTRACT
| FULL TEXT
Thorax in focus: chronic obstructive pulmonary disease
Hodgson et al.
Thorax 2012;67:171-176.
ABSTRACT
| FULL TEXT
Republished editorial: Targeting lung attacks
FitzGerald
Postgrad. Med. J. 2011;87:655-656.
FULL TEXT
Is Atherosclerotic Heart Disease in COPD a Distinct Phenotype?
Man et al.
Chest 2011;140:569-571.
FULL TEXT
Biochemical markers of cardiac dysfunction predict mortality in acute exacerbations of COPD
Chang et al.
Thorax 2011;66:764-768.
ABSTRACT
| FULL TEXT
Are beta2-agonists responsible for increased mortality in heart failure?
Bermingham et al.
Eur J Heart Fail 2011;13:885-891.
ABSTRACT
| FULL TEXT
Effect of {beta} blockers in treatment of chronic obstructive pulmonary disease: a retrospective cohort study
Short et al.
BMJ 2011;342:d2549-d2549.
ABSTRACT
| FULL TEXT
Treatment with {beta} blockers in people with COPD
Kazani and Israel
BMJ 2011;342:d2655-d2655.
FULL TEXT
Targeting lung attacks
FitzGerald
Thorax 2011;66:365-366.
FULL TEXT
Can beta-blockers be used for people with COPD?
DTB 2011;49:2-5.
ABSTRACT
| FULL TEXT
Systemic Manifestations of COPD
Nussbaumer-Ochsner and Rabe
Chest 2011;139:165-173.
ABSTRACT
| FULL TEXT
30 Chronic lung disease
Greenstone et al.
Oxford Textbook of Heart Failure 2011;1:med-9780199577729-chapter-med-9780199577729-chapter.
ABSTRACT
| FULL TEXT
{beta}-Blockers for Chronic Obstructive Pulmonary Disease?
Journal Watch Hospital Medicine 2010;2010:1-1.
FULL TEXT
A Curious Case of {beta}-Blockers in Chronic Obstructive Pulmonary Disease
Sin and Man
Arch Intern Med 2010;170:849-850.
FULL TEXT
|
