TY - JOUR
T1 - Investigating the adverse respiratory effects of beta-blocker treatment: six years of prospective longitudinal data in a cohort with cardiac disease
AU - Cochrane, Belinda
AU - Quinn, Stephen
AU - Walters, Hayden
AU - Young, Iven
PY - 2012/7
Y1 - 2012/7
N2 - Background: Globally, cardiovascular disease (CVD) is the leading cause of death. Beta-blocker medications have well-established survival benefit for myocardial infarction and heart failure. However, CVD frequently coexists with chronic obstructive airways disease (COPD), a disease in which beta-blockers are traditionally avoided. Aim: We sought to investigate the adverse respiratory effects associated with long-term beta-blocker treatment in patients with cardiac disease, and presumed high risk of COPD. Methods: In this prospective cohort study, patients admitted with acute cardiac disease were recruited from the cardiology unit of a tertiary referral hospital. The treating cardiologist determined beta-blocker treatment, independent of the study. Repeated measures of spirometry and respiratory symptom scores were assessed over 12months. Respiratory exacerbations, cardiac events and survival were recorded over 6years. Outcomes were compared according to beta-blocker exposure. Results: Sixty-four subjects participated, 30 of whom received beta-blockers. Beta-blockers did not adversely affect spirometry, respiratory symptoms or survival. However, considering two categories of respiratory exacerbations (symptom-based vs treated), subjects taking beta-blockers accumulated increased annual risk (relative risk (RR) 1.30, 95% confidence interval (CI) 1.11-1.53, P= 0.001 and RR 1.37, 95% CI 1.09-1.72, P= 0.008) and concluded with overall increased risk (RR 3.67, 95% CI 1.65-8.18, P= 0.001 and RR 4.03, 95% CI 1.26-12.9, P= 0.019), when compared with the group not taking beta-blockers. Conclusion: Long-term beta-blocker treatment did not adversely affect lung function, respiratory symptom scores or survival, but was associated with increased risk of respiratory exacerbations.
AB - Background: Globally, cardiovascular disease (CVD) is the leading cause of death. Beta-blocker medications have well-established survival benefit for myocardial infarction and heart failure. However, CVD frequently coexists with chronic obstructive airways disease (COPD), a disease in which beta-blockers are traditionally avoided. Aim: We sought to investigate the adverse respiratory effects associated with long-term beta-blocker treatment in patients with cardiac disease, and presumed high risk of COPD. Methods: In this prospective cohort study, patients admitted with acute cardiac disease were recruited from the cardiology unit of a tertiary referral hospital. The treating cardiologist determined beta-blocker treatment, independent of the study. Repeated measures of spirometry and respiratory symptom scores were assessed over 12months. Respiratory exacerbations, cardiac events and survival were recorded over 6years. Outcomes were compared according to beta-blocker exposure. Results: Sixty-four subjects participated, 30 of whom received beta-blockers. Beta-blockers did not adversely affect spirometry, respiratory symptoms or survival. However, considering two categories of respiratory exacerbations (symptom-based vs treated), subjects taking beta-blockers accumulated increased annual risk (relative risk (RR) 1.30, 95% confidence interval (CI) 1.11-1.53, P= 0.001 and RR 1.37, 95% CI 1.09-1.72, P= 0.008) and concluded with overall increased risk (RR 3.67, 95% CI 1.65-8.18, P= 0.001 and RR 4.03, 95% CI 1.26-12.9, P= 0.019), when compared with the group not taking beta-blockers. Conclusion: Long-term beta-blocker treatment did not adversely affect lung function, respiratory symptom scores or survival, but was associated with increased risk of respiratory exacerbations.
KW - Adrenergic
KW - Beta-blocker
KW - COPD
KW - Disease exacerbation
KW - Heart disease
KW - Undesirable effect
UR - http://www.scopus.com/inward/record.url?scp=84864042652&partnerID=8YFLogxK
U2 - 10.1111/j.1445-5994.2011.02563.x
DO - 10.1111/j.1445-5994.2011.02563.x
M3 - Article
VL - 42
SP - 786
EP - 793
JO - Internal Medicine Journal
JF - Internal Medicine Journal
SN - 0004-8291
IS - 7
ER -