Multicentric study on the beta-blocker use and relation with exacerbations in COPD

Summary Chronic obstructive pulmonary disease (COPD) is frequently associated with chronic heart failure (CHF) or coronary artery disease (CAD). In spite of the recommendation to use beta-blockers (BB) they are likely under-prescribed to patients with concurrent COPD and heart diseases. To find out the prevalence of use of BB, 256 COPD patients were consecutively recruited by pulmonary physicians from 14 hospitals in 7 regions of Spain in their outpatient offices if they had a diagnosis of COPD, were not on long-term oxygen therapy, had CHF or CAD, and met the criteria for BB treatment. In patients with indication 58% (95%CI, 52–64%) of the COPD patients and 97% of the non-COPD patients were on BB ( p 70, OR 2.19 (1.24–3.86) use of long-acting beta 2 -agonists OR = 2.18 (1.29–3.68), previous episodes of left ventricular failure OR 2.27 (1.19–4.33) and diabetes, OR = 1.82 (1.08–3.38). We conclude that, according to what is recommended by current guidelines, BB are still under-prescribed in COPD patients. COPD patients with CHF or CAD using BB suffer fewer exacerbations and visits to the ER. GOLD stage, use of long-acting beta 2 -agonists, baseline heart rate and comorbidities are also risk factors for exacerbations in this population.