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Therapeutic effects of the combination of inhaled beta2-agonists and beta-blockers in COPD patients with cardiovascular disease

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Abstract

Chronic obstructive pulmonary disease (COPD) is a major health problem worldwide, with co-morbidities contributing to the overall severity and mortality of the disease. The incidence and prevalence of cardiovascular disease among COPD patients are high. Both disorders often co-exist, mainly due to smoking, but they also share common underlying risk factors, such as aging and low-grade systemic inflammation. The therapeutic approach is based on agents, whose pharmacological properties are completely opposed. Beta2-agonists remain the cornerstone of COPD treatment due to their limited cardiac adverse effects. On the other hand, beta-blockers are administered in COPD patients with cardiovascular disease, but despite their proven cardiac benefits, they remain underused. There is still a trend among physicians over underprescription of these drugs in patients with heart failure and COPD due to bronchoconstriction. Therefore, cardioselective beta-blockers are preferred, and recent meta-analyses have shown reduced rates in mortality and exacerbations in COPD patients treated with beta-blockers.

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Authors and Affiliations

  1. Medical School, Postgraduate Study Program (MSc) “Cardiopulmonary Resuscitation”, National and Kapodistrian University of Athens, Athens, Greece

    Vasiliki Petta & Athanasios Chalkias

  2. Pulmonary Division, Department of Critical Care, University of Athens Medical School, Evangelismos Hospital, Athens, Greece

    Fotis Perlikos & Georgios Hillas

  3. 2nd Department of Respiratory Medicine, National and Kapodistrian University of Athens, Medical School, Attikon University Hospital, Athens, Greece

    Stelios Loukides

  4. 1st Department of Respiratory Medicine, National and Kapodistrian University of Athens, Medical School, Sotiria University Hospital, Athens, Greece

    Petros Bakakos

  5. Hellenic Society of Cardiopulmonary Resuscitation, Athens, Greece

    Athanasios Chalkias, Nicoletta Iacovidou & Theodoros Xanthos

  6. Department of Neonatology, National and Kapodistrian University of Athens, Medical School, Aretaieio University Hospital, Athens, Greece

    Nicoletta Iacovidou

  7. European University Cyprus, School of Medicine, Nicosia, Cyprus

    Theodoros Xanthos

  8. Department of Cardiology, National and Kapodistrian University of Athens, Medical School, Aretaieio University Hospital, Athens, Greece

    Dorothea Tsekoura

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Petta, V., Perlikos, F., Loukides, S. et al. Therapeutic effects of the combination of inhaled beta2-agonists and beta-blockers in COPD patients with cardiovascular disease. Heart Fail Rev 22, 753–763 (2017). https://doi.org/10.1007/s10741-017-9646-z

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