Myths about Usage of Beta-Blockers
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2017, Vol 16, Issue 9
Abstract
Background: Beta-blocker therapy has a proven benefit in patients with hypertension, heart failure and Coronary Artery Disease (CAD) and have been considered contraindicated in patients with Chronic Obstructive Pulmonary Disease (COPD). Although beta-blockers improve cardiovascular outcomes, COPD patients not receive them because possible adverse pulmonary effects. We aimed to identify factors associated with beta-blocker used in this setting and to determine whether their use is associated with decreased in-hospital mortality. Methods: Randomised, blinded, controlled trials of single dose or one year duration that studied the effects of cardioselective beta-blockers on the FEV1 or symptoms in patients with COPD. We reviewed data with acute exacerbation of COPD as primary diagnosis or as secondary diagnosis with a primary diagnosis of acute respiratory disease. Demographics, co-morbidities, and medication use were recorded and patients receiving beta-blockers were compared to normal patients. Multivariate regression analysis was done to determine predictors of in-hospital death. Results: Of the 325 patients (mean age, 66 ± 12 yr; 73% male), 68(31%) received cardioselective beta-blockers at their initial hospitalization (Table1).b-blockers used were bisoprolol at 50% (162), atenolol at 15% (49), and metoprolol at 32% (104). The percentage of b-blocker use was (mild COPD, 39%; moderate COPD, 35%; and severe COPD, 33%). In multivariate analysis, beta-blocker use was associated with reduced mortality. Conclusions: Beta-blocker use among inpatients with exacerbations of COPD is well tolerated and may be associated with reduced mortality.The potential protective effect of beta-blockers in this population warrants further study.
Authors and Affiliations
Dr. K. Muralidharan, Dr. C. Sanjay
Keywords
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- DOI 10.9790/0853-1609083235
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