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Chronic obstructive pulmonary isease (COPD) involves a group of progressive lung disorders characterized by persistent airflow limitation and chronic respiratory symptoms. Asthma-COPD Overlap Syndrome (ACOS), encompassing features of both asthma and Chronic obstructive pulmonary disease (COPD), is a group of progressive lung disorders that includes chronic bronchitis, emphysema, and refractory (non-reversible) asthma. ACOS leads to complex clinical presentations that combine the inflammatory...
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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,...
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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...
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Related Experiment Video

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Home-Based Prescribed Pulmonary Exercise in Patients with Stable Chronic Obstructive Pulmonary Disease
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Beta-blocker under-use in COPD patients.

Kuan Pin Lim1,2, Sarah Loughrey1, Michael Musk1,2

  • 1Advanced Lung Disease Unit, Royal Perth Hospital, Perth, WA, Australia.

International Journal of Chronic Obstructive Pulmonary Disease
|November 2, 2017
PubMed
Summary
This summary is machine-generated.

Beta-blockers (BBs) are under-prescribed in patients hospitalized with chronic obstructive pulmonary disease (COPD) exacerbations, despite evidence of benefit. This underuse may contribute to cardiovascular complications and poorer patient outcomes.

Keywords:
COPD exacerbationsbeta-blockerscardiovascularcomorbidity

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Area of Science:

  • Pulmonary Medicine
  • Cardiology
  • Clinical Pharmacy

Background:

  • Cardiovascular (CVS) comorbidities are prevalent in patients with chronic obstructive pulmonary disease (COPD) and significantly increase morbidity and mortality, particularly after acute exacerbations (AECOPD).
  • Beta-blockers (BBs) are established as safe and effective for COPD patients, offering a survival advantage post-myocardial infarction.
  • Underutilization of BBs in hospitalized AECOPD patients and the incidence/impact of CVS and cerebrovascular complications warrant investigation.

Purpose of the Study:

  • To evaluate the prescribing patterns of BBs in hospitalized patients diagnosed with AECOPD.
  • To determine the rates of inpatient CVS and cerebrovascular complications in this patient cohort.
  • To assess the association between BB use and patient outcomes, including length of stay and mortality.

Main Methods:

  • A retrospective analysis of hospital data was conducted over a 12-month period.
  • Medical records of patients over 40 years old with an AECOPD diagnosis were reviewed.
  • Prevalent BB use, incident BB initiation, and relevant comorbidities (indications/contraindications) were assessed.

Main Results:

  • Of 366 eligible patients, 42.6% had an indication for BBs, yet only 34.0% were prescribed BBs, and 39.1% had no contraindication but were not on therapy.
  • Prevalent BB use (19.7%) was lower than that of anti-platelets (45.6%), statins (39.6%), and ACEI/ARBs (45.9%).
  • CVS and cerebrovascular complications occurred in 16% of patients, correlating with longer hospital stays (p<0.01) and increased inpatient mortality (p=0.02).

Conclusions:

  • Beta-blockers are significantly under-prescribed in COPD patients with clear indications for their use.
  • Further research is necessary to identify and address the barriers to BB prescribing in this vulnerable population.
  • Optimizing BB use in AECOPD patients could potentially reduce cardiovascular complications and improve clinical outcomes.