The balancing act

It’s been a battle for the ages – you’ve got a 70 year old patient who has been a heavy smoker in the past, resulting in the double whammy of ischaemic heart disease and COPD. Of course, aspirin, statins and ACE-inhibitors will come in from the cardiology side, and some long acting bronchodilators and inhaled steroids from the respiratory side – but what about beta blockers?

The standard approach has been to just avoid them, with most people of the belief that it will simply worsen the respiratory status, and that the cardiac risk is not too great. In the BMJ, this retrospective cohort study from Short and colleagues looks at beta blocker use in those with a diagnosis of COPD. Contrary to popular belief, beta blockers reduced all cause mortality and had no significant negative impact on lung function.

Definitely an interesting read and sets up a large randomised controlled trial for the future nicely – check out the full text at the BMJ here

More on this over at JACC.

IMAGE Pulmonary Pathology


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