Beta-blockers cut COPD exacerbations, especially in heart failure patients

by Bruce Sylvester: Treatment with cardioselective  beta-blockers appears to reduce the risk of exacerbations in chronic obstructive pulmonary disease (COPD),  and it is especially effective in preventing COPD exacerbations in patients with heart failure, researchers reported on March 12, 2016 at the European Respiratory Society’s Lung Science Conference in Estoril, Portugal.

Lies Lahaousse MD, lead author and postdoctoral fellow at Ghent University Hospital in Belgium, said, “The overlap in symptoms and risk factors associated with lung and heart disease can be complicated, and we know that a reduction in lung function is also associated with a reduction in heart function. These preliminary findings offer a useful insight into the potential benefits of beta blockers for patients living with heart disease at the same time as COPD. If randomised controlled trials confirm our findings, we could see promising clinical implications.”

As background, the authors noted that while β-blockers are known to protect patients with cardiovascular disease, some retrospective studies also suggest that β-blockers could also benefit patients with COPD. The purpose of this new study was to investigate whether β-blockers have a beneficial effect on the risk of COPD exacerbations.

The researchers retrospectively analysed data on 1,621 COPD patients included in the Rotterdam Study.

They tracked each subject until an exacerbation occurred, and they collected data on use of various of beta-blockers. They also tracked each subject for heart failure.

They discovered exacerbations in 1,136 of the subjects, 268 of which were severe..

They found that treatment with  cardioselective beta-blockers, which are primarily used to treat heart disease, reduced the relative risk of exacerbations by 21%. Notably, the prophylactic effect increased among patients with heart failure, who achieved a reduced exacerbation risk of 55%.

They found no protective effect for non-cardioselective β-blockers.

The authors concluded, “Use of cardioselective β-blockers is associated with a reduced risk of COPD exacerbations. Further research should reveal whether this association is causal or due to confounding, and whether reduced exacerbation risk translates in reduced mortality.”