Clinical Citations: Antihypertensive therapy and COPD: The effect of ß-blockers on mortality

Cardiovascular disease is a leading cause of death in patients with chronic obstructive pulmonary disease (COPD). While some physicians may be reluctant to prescribe ß-blockers for these patients, because of concern about adverse effects on lung function, a study conducted by Au and associates indicates that ß-blockers may have an edge over other antihypertensive agents in reducing mortality risk.

The study included 1966 patients who had COPD and were receiving single-agent therapy for hypertension. Most of the patients (97.5%) were male; the mean patient age was 65.8 years. Compared with calcium channel blocker therapy, ß-blocker therapy was associated with reduced mortality from any cause (hazard ratio, 0.57).

A similar pattern was observed when ß-blockers were compared with other antihypertensive agents. Calcium channel blockers were not associated with increased mortality risk when compared with these other agents.

Adjustment for comorbidity and the severity of lung disease did not significantly affect the association between ß-blocker therapy and all-cause mortality, and the reduced mortality risk was observed in patients who had preexisting cardiac disease. Moreover, this study found that the use of ß-blockers was not associated with an increased risk of COPD exacerbations.