Beta-blockers in patients with chronic obstructive pulmonary disease: for whom, when, how?


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Abstract

Chronic obstructive pulmonary disease (COPD) is the most common chronic respiratory disease, and its prevalence is increasing worldwide, both in industrialized and developing countries. The prevalence of COPD is about 5% among the general population, and it is the fourth leading cause of death in the world. COPD is closely associated with cardiovascular diseases (CVDs). About 64% of people with COPD are treated for concomitant cardiovascular disease, and approximately one in three patients with COPD dies as a result of cardiovascular diseases. Currently, therapy with selective β1-blockers is considered safe for patients with CVDs and COPD. Regular administration of selective β1-blockers has a significant impact on the survival of patients with COPD in combination with coronary artery disease and chronic heart failure. Bisoprolol, metoprolol or nebivolol are the most safe drugs. There is no convincing data on the benefits of prescribing ß-blockers for patients with COPD without CVD. For safety reasons, it is necessary to start taking ß-blockers with a small dose outside the period of COPD exacerbation and carefully monitor the possible occurrence of new symptoms (for example, shortness of breath, decreased exercise tolerance, cough) or changes in drug intake (for example, increased need for inhaled ß-agonists). The appointment of adequate bronchodilator therapy (preferably long-acting anticholinergics) when taking ß-blockers is considered to be important.

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About the authors

Nina A. Karoli

Saratov State Medical University n.a. V.I. Razumovsky

Email: nina.karoli.73@gmail.com
Dr. Sci. (Med.), Professor at the Department of Hospital Therapy, Faculty of Medicine 112, Bolshaya Kazachya str., Saratov 410012, Russian Federation

A. P Rebrov

Saratov State Medical University n.a. V.I. Razumovsky

Department of Hospital Therapy, Faculty of Medicine Saratov, Russia

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