Beta Blockers and Chronic Obstructive Pulmonary Disease (COPD): Sum of Evidence

2020 ◽  
Vol 16 ◽  
Author(s):  
Katerina Baou ◽  
Vasiliki Katsi ◽  
Thomas Makris ◽  
Dimitris Tousoulis
Keyword(s):  
Heart Failure ◽  
Chronic Obstructive Pulmonary Disease ◽  
Coronary Artery Disease ◽  
Pulmonary Disease ◽  
Cardiac Arrhythmias ◽  
Beta Blockers ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Artery Disease

Abstract:: Approximately, half a century has passed since the discovery of beta blockers. Then, their prime therapeutic purpose was to treat angina and cardiac arrhythmias, nowadays, beta blockers’ usage and effectiveness is extended to treat other cardiovascular diseases, such as hypertension, congestive heart failure, and coronary artery disease. Safety concerns were raised about beta blockers and their use for chronic obstructive pulmonary disease (COPD) patients with concurrent cardiovascular disease. After a thorough research of the literature, this review summarizes the evidence proving that beta blockers not only might be well tolerated in COPD patients, but they might also have a beneficial effect in this group of patients.

scholarly journals Association of asthma–chronic obstructive pulmonary disease overlap syndrome with coronary artery disease, cardiac dysrhythmia and heart failure: a population-based retrospective cohort study

BMJ Open ◽  
2017 ◽  
Vol 7 (10) ◽  
pp. e017657 ◽  
Author(s):  
Jun-Jun Yeh ◽  
Yu-Feng Wei ◽  
Cheng-Li Lin ◽  
Wu-Huei Hsu
Keyword(s):  
Heart Failure ◽  
Chronic Obstructive Pulmonary Disease ◽  
Coronary Artery Disease ◽  
Beta Blockers ◽  
Overlap Syndrome ◽  
Chronic Obstructive ◽  
Cardiac Dysrhythmia ◽  
Obstructive Pulmonary Disease ◽  
Artery Disease ◽  
The Relationship

ObjectivesPatients with asthma–chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS) and cardiovascular diseases (CVDs) share common risk factors. However, the association between ACOS and the incidence of CVDs has not been reported. This study investigated the relationship between CVDs and ACOS in the general population.SettingData were obtained from Taiwan’s National Health Insurance Research Database for the period 2000 to 2010.ParticipantsThe ACOS cohort comprised patients (n=5814) who had received a diagnosis of asthma and COPD. The non-ACOS cohort comprised patients who had not received a diagnosis of asthma or COPD and were matched to the ACOS cohort (2:1) by age, sex and index date (n=11 625).Primary and secondary outcome measuresThe cumulative incidence of CVDs—coronary artery disease (CAD), cardiac dysrhythmia (CD) and heart failure (HF)—was calculated. Cox proportional regression analysis was employed to examine the relationship between ACOS and CVDs.ResultsAfter adjustment for multiple confounding factors—age, sex, comorbidities and medications—patients with ACOS were associated with a significantly higher risk of CVDs; the adjusted HRs (aHRs; 95% CI) for CAD, CD and HF were 1.62 (1.50 to 1.76), 1.44 (1.30 to 1.61) and 1.94 (1.73 to 2.19), respectively, whereas those of beta-blockers treatment for CAD, CD and HF were 1.19 (0.92 to 1.53), 0.90 (0.56 to 1.45) and 0.82 (0.49 to 1.38). The aHR of atenolol treatment for CD was 1.72 (1.01 to 2.93). The aHRs (95% CIs) of ACOS without acute exacerbation of COPD (AE-COPD) for CAD, CD and HF were 1.85 (1.70 to 2.01), 1.57 (1.40 to 1.77) and 2.07 (1.82 to 2.35), respectively.ConclusionACOS was associated with higher CVD risk, even without the presence of previous comorbidities or AE-COPD. No significant differences in CVD events were observed in the ACOS cohort using beta-blockers, except for those using atenolol for treating CD.

scholarly journals Comorbidity of Chronic Obstructive Pulmonary Disease and Cardiovascular Diseases: Place of Therapy with Modern β-Adrenoblockers

Kardiologiia ◽  
2019 ◽  
Vol 59 (6) ◽  
pp. 48-55 ◽  
Author(s):  
Yu. N. Belenkov ◽  
O. A. Tsvetkova ◽  
E. V. Privalova ◽  
G. V. An ◽  
I. S. Ilgisonis ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Cardiovascular Diseases ◽  
Pulmonary Disease ◽  
Beta Blockers ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Common Risk Factors ◽  
Artery Disease ◽  
Morbidity Risk

Chronic obstructive pulmonary disease (COPD) is the fourth largest cause of worldwide mortality.  Presence of comorbidities is registered in 96% of COPD patients. The most important of these are cardiovascular diseases (coronary artery disease, arterial hypertension, chronic heart failure), which contribute to COPD patients’ mortality in every third case. COPD and cardiovascular diseases have common risk factors and pathogenesis mechanisms. Cardioselective beta-blockers reduce morbidity risk and frequency of COPD exacerbation, are effective and safe in treatment of COPD patients.

scholarly journals ’Who Cares?' The experiences of caregivers of adults living with heart failure, chronic obstructive pulmonary disease and coronary artery disease: a mixed methods systematic review

BMJ Open ◽  
2018 ◽  
Vol 8 (7) ◽  
pp. e020927 ◽  
Author(s):  
Miriam Catherine Noonan ◽  
Jennifer Wingham ◽  
Rod S Taylor
Keyword(s):  
Heart Failure ◽  
Systematic Review ◽  
Chronic Obstructive Pulmonary Disease ◽  
Coronary Artery Disease ◽  
Mixed Methods ◽  
Coronary Artery ◽  
Pulmonary Disease ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Artery Disease

ObjectiveTo assess the experiences of unpaid caregivers providing care to people with heart failure (HF) or chronic obstructive pulmonary disease (COPD) or coronary artery disease (CAD).DesignMixed methods systematic review including qualitative and quantitative studies.Data sourcesDatabases searched: Medline Ebsco, PsycInfo, CINAHL Plus with Full Text, Embase, Web of Science, Ethos: The British Library and ProQuest. Grey literature identified using: Global Dissertations and Theses and Applied Sciences Index and hand searches and citation checking of included references. Search time frame: 1 January 1990 to 30 August 2017.Eligibility criteria for selecting studiesInclusion was limited to English language studies in unpaid adult caregivers (>18 years), providing care for patients with HF, COPD or CAD. Studies that considered caregivers for any other diagnoses and studies undertaken in low-income and middle-income countries were excluded. Quality assessment of included studies was conducted by two authors.Data analysis/synthesisA results-based convergent synthesis was conducted.ResultsSearches returned 8026 titles and abstracts. 54 studies—21 qualitative, 32 quantitative and 1 mixed method were included. This totalled 26 453 caregivers who were primarily female (63%), with median age of 62 years. Narrative synthesis yielded six concepts related to caregiver experience: (1) mental health, (2) caregiver role, (3) lifestyle change, (4) support for caregivers, (5) knowledge and (6) relationships. There was a discordance between paradigms regarding emerging concepts. Four concepts emerged from qualitative papers which were not present in quantitative papers: (1) expert by experience, (2) vigilance, (3) shared care and (4) time.ConclusionCaregiving is life altering and complex with significant health implications. Health professionals should support caregivers who in turn can facilitate the recipient to manage their long-term condition. Further longitudinal research exploring the evolution of caregiver experiences over time of patients with chronic cardiopulmonary conditions is required.Trial registration numberCRD42016053412

scholarly journals Biological effects of ticagrelor over clopidogrel in patients with stable coronary artery disease and chronic obstructive pulmonary disease

2017 ◽  
Vol 117 (06) ◽  
pp. 1208-1216 ◽  
Author(s):  
Gianluca Campo ◽  
Francesco Vieceli Dalla Sega ◽  
Rita Pavasini ◽  
Giorgio Aquila ◽  
Francesco Gallo ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Endothelial Function ◽  
Pulmonary Disease ◽  
Primary Endpoint ◽  
Stable Coronary Artery Disease ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Artery Disease

SummaryPatients with SCAD and concomitant COPD are at high risk of cardiovascular adverse events, due to chronic inflammation, responsible of endothelial dysfunction, oxidative stress and heightened platelet reactivity (PR). The objective of this randomised clinical trial was to test if ticagrelor is superior to clopidogrel in improving endothelial function in patients with stable coronary artery disease (SCAD) and concomitant chronic obstructive pulmonary disease (COPD). Forty-six patients with SCAD and COPD undergoing percutaneous coronary intervention (PCI) were randomly assigned to receive clopidogrel (n=23) or ticagrelor (n=23) on top of standard therapy with aspirin. The following parameters were assessed at baseline and after 1 month: i) rate of apoptosis and ii) nitric oxide (NO) levels in human umbilical vein endothelial cells (HUVECs), iii) levels of reactive oxygen species (ROS) in peripheral blood mononuclear cell, iv) 29 cytokines/chemokines, v) on-treatment PR. The primary endpoint of the study was the 1-month rate of HUVECs apoptosis. The rate of apoptosis after 1 month was significantly lower in patients treated with ticagrelor (7.4 ± 1.3% vs 9.3 ± 1.5%, p<0.001), satisfying the pre-specified primary endpoint. In the ticagrelor arm, levels of NO were higher (10.1 ± 2.2 AU vs 8.5 ± 2.6 AU, p=0.03) while those of ROS (4 ± 1.8 AU vs 5.7 ± 2.8 AU, p=0.02) and P2Y12 reactivity units (52 ± 70 PRU vs 155 ± 62 PRU, p<0.001) were lower. There were no differences in cytokines/chemokines levels and aspirin reactivity units between groups. In patients with SCAD and COPD undergoing PCI, ticagrelor, as compared to clopidogrel is superior in improving surrogate markers of endothelial function and on-treatment PR (ClinicalTrials.gov, NCT02519608).Supplementary Material to this article is available online at www.thrombosis-online.com.

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