Related Experiment Video

Updated: Feb 23, 2026

Cardiac Response to β-Adrenergic Stimulation Determined by Pressure-Volume Loop Analysis
08:05

Cardiac Response to β-Adrenergic Stimulation Determined by Pressure-Volume Loop Analysis

Published on: May 19, 2021

4.1K

The evaluation of β-adrenoceptor blocking agents in patients with COPD and congestive heart failure: a nationwide

Kuang-Ming Liao1, Tien-Yu Lin2,3, Yaw-Bin Huang2,3

  • 1Department of Internal Medicine, Chi Mei Medical Center, Chiali, Tainan.

International Journal of Chronic Obstructive Pulmonary Disease
|September 13, 2017
PubMed

Insights

Beta-blockers improve survival in patients with heart failure and COPD. High-dose bisoprolol significantly reduces mortality and hospitalizations for heart failure exacerbations in these patients.

Area of Science:

  • Cardiology
  • Pulmonology
  • Pharmacology

Background:

  • Beta-blockers are established treatments for congestive heart failure (CHF) and are considered safe for patients with chronic obstructive pulmonary disease (COPD).
  • The comparative effectiveness of different beta-blocker agents and their impact on exacerbations in patients with both conditions remain unclear.

Purpose of the Study:

  • To compare the outcomes of various beta-blockers in patients diagnosed with both congestive heart failure and chronic obstructive pulmonary disease.
  • To investigate the association between beta-blocker use and exacerbations of CHF and COPD.

Main Methods:

  • A retrospective cohort study utilizing Taiwan's National Health Insurance Research Database.
  • Inclusion criteria involved patients diagnosed with CHF (>20 years old) and COPD (frequent outpatient visits or hospitalization).
  • A time-dependent Cox proportional hazards regression model was employed to assess beta-blocker effectiveness.

Main Results:

  • 1,872 patients with concurrent CHF and COPD were identified.
  • High-dose bisoprolol significantly reduced mortality (aHR=0.51) and CHF exacerbation hospitalizations (aHR=0.48).
  • No significant association was found between beta-blocker use and COPD exacerbation.

Conclusions:

  • Beta-blockers are associated with reduced mortality and hospitalizations for CHF exacerbations in patients with co-existing CHF and COPD.
  • Bisoprolol demonstrated superior outcomes in reducing mortality and CHF exacerbations compared to carvedilol and metoprolol.
  • Beta-blocker therapy did not show an association with COPD exacerbations.
Abstract

Keywords:
COPDacute exacerbationcongestive heart failureβ-blockers

Related Concept Videos

Heart Failure Drugs: β-Blockers01:22

Heart Failure Drugs: β-Blockers

β-adrenergic antagonists, commonly known as β-blockers, block the effects of sympathetic neurotransmitters such as noradrenaline (NA) and adrenaline (ADR). They have several beneficial effects in heart failure treatment. They reduce heart rate, the force of contraction, and cardiac muscle relaxation. They also slow the atrial-ventricular conduction rate and raise the threshold for arrhythmias. The concentration of β-blockers determines their effects on bronchodilation,...
1.0K
Antihypertensive Drugs: Types of β-Blockers01:28

Antihypertensive Drugs: Types of β-Blockers

β receptors are classified into three subclasses: β1, β2, and β3. β1 receptors are primarily located in the heart and kidneys. When they get activated, they increase heart rate, contractility, and renin release. This process enhances blood pressure and aids in stress management. In contrast, β2 receptors are situated mainly in the lungs, blood vessels, and skeletal muscles. Upon activation, they trigger smooth muscle relaxation, causing bronchodilation and...
1.8K
Adrenergic Antagonists: Pharmacological Actions of β-Receptor Blockers01:27

Adrenergic Antagonists: Pharmacological Actions of β-Receptor Blockers

β-receptor blockers significantly impact the cardiovascular system by counteracting catecholamine-induced sympathetic responses. These medications decrease heart rate, contractility, and cardiac output, potentially leading to cardiac depression, life-threatening bradycardia, and death. Therapeutically, β-blockers function as mild antihypertensives and are utilized in treating angina pectoris and cardiac arrhythmias. However, nonselective β-blockers inhibit β2-receptors in...
1.8K
Adrenergic Antagonists: Chemistry and Classification of β-Receptor Blockers01:25

Adrenergic Antagonists: Chemistry and Classification of β-Receptor Blockers

β-adrenergic antagonists, or β-blockers, modulate the sympathetic nervous system by targeting β-adrenoceptors and inhibiting catecholamine-mediated sympathetic responses. β-blockers differ in their adrenoceptor subtype affinity, lipophilicity, and α-blocking capabilities. The history of β-blocker development began with the prototype, dichloroisoprenaline, which exhibited partial agonist activity. As a result, propranolol was developed as a pure antagonist but...
1.6K
Heart Failure Drugs: Inhibitors of Renin-Angiotensin System01:26

Heart Failure Drugs: Inhibitors of Renin-Angiotensin System

The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
1.2K
Adrenergic Antagonists: ɑ and β-Receptor Blockers01:31

Adrenergic Antagonists: ɑ and β-Receptor Blockers

Third-generation β-blockers, such as labetalol and carvedilol, represent a significant advancement in managing cardiovascular conditions. Unlike conventional β-blockers, which can induce peripheral vasoconstriction, third-generation drugs block α1 adrenoceptors. This promotes vasodilation through several mechanisms, such as increased nitric oxide production, inhibition of calcium ion entry, opening of potassium ion channels, and antioxidant action. Labetalol, for instance, is...
1.3K