Beta Blockers Effective In Heart Failure Complicated By Lung Disease

(Reuters Health) The use of beta-blocker therapy in patients with congestive heart failure (CHF) complicated by airway disease does not increase the rate of respiratory events and may actually improve outcome, according to results presented here today at CHEST 2004, the 70th annual meeting of the American College of Chest Physicians.

Lead investigator Dr. Jay I. Peters, of the University of Texas Health Science Center at San Antonio, said the take-home message is that "beta blockers should not be considered a contraindication for these patients." Moreover, "in certain patients, particularly those who are scheduled for cardiac surgery or post-myocardial infarction patients, beta blockers have a proven survival benefit."

He noted that although older studies suggested that beta blockers were contraindicated in patients with chronic obstructive lung disease (COPD) and asthma more recent studies raise questions about that advice. For example, he said that newer studies found that cardioselective beta blockers carry no increased respiratory risk and may "enhance the effect of inhaled beta-agonists."

Dr. Peters' study is a retrospective analysis of prospectively collected data on the outcome of patients with congestive heart failure. A total of 1067 CHF patients were enrolled in the study. Of those, 5.9% of the patients had asthma, 11.2% had COPD and 2.5% had both COPD and asthma.

"So 209 patients could have benefited from beta-blockers," he said. "However, only 35.9% of these patients did receive beta-blocker therapy."

Overall, patients with COPD and asthma were three times more likely to have respiratory events, he said. "But when we selected out those patients with COPD or asthma who were taking beta blockers there was no increase in respiratory events -- rather they had a statistically significant lower rate of respiratory events (p = 0.003)."

The study was funded by the U.S. Department of Defense

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