Cardioselective beta-blockers significantly reduce mortality in patients with chronic obstructive pulmonary disease (COPD), according to new study findings that run contrary to previous thinking. The study involved more than 3,300 patients who underwent major vascular surgery at one facility between 1990 and 2006. Patients were divided into those with COPD and those without COPD. Researchers analyzed the effect of low-dose beta-blockers (less than 25% of the maximum recommended therapeutic dose) compared with an intensified dose (more than 25% of the maximum recommended therapeutic dose). They found that cardioselective beta-blockers such as bisoprolol were associated with lower 30-day mortality in all patients. In the month after surgery, patients with COPD who didn't take beta-blockers were twice as likely to die as those who did (8% versus 4%).

During follow-up, 67% of patients with COPD who didn't take beta-blockers died, compared with 40% of patients with COPD who took beta-blockers. Only the intensified drug dose was associated with reduced 30-day mortality, but in the long-term, both doses produced similar reductions in mortality.

Cardioselective beta-blockers may prevent late cardiac events, a major cause for morbidity and mortality. The researchers conclude that "the use of cardioselective beta-blockers appears to be safe and associated with reduced mortality."

Source: van Gestel YRBM, Hoeks SE, Sin DD, et al. Impact of cardioselective beta-blockers on mortality in patients with chronic obstructive pulmonary disease and atherosclerosis. Am J Respir Crit Care Med. 2008;178(7):695-700.