Effect of long-term treatment with celiprolol on pulmonary function in a group of mild hypertensive asthmatics

Previous studies have shown that single dose or short-term administration of celiprolol does not impair pulmonary function in patients with asthma. The long-term effects of celiprolol and chlorthalidone on respiratory function in mild hypertensive asthmatic patients were compared. Following a 1-month placebo washout period, five patients were randomized to 3 months of treatment with celiprolol, and four patients were treated with chlorthalidone. This double-blind study was followed by a 12-month open trial in 13 asthmatics. Forced expiratory volume at the first second of expiration (FEV1) remained unchanged throughout the 12-month treatment period. This finding is of interest since a spontaneous decrease in FEV1 of 20 ml/year has been observed in recent surveys of asthmatic patients. No changes in peak expiratory flow rate or maximum expiratory flow at 50% of vital capacity were observed during the study, but measurements of FEV1 before and 2 h after drug administration indicated that celiprolol had no direct bronchodilating effect. The responsiveness to inhaled salbutamol was unaltered during the 12-month trial period, demonstrating that celiprolol does not block the beta 2-adrenoceptors on bronchial smooth muscle. Our results indicate that celiprolol is a safe long-term treatment for hypertension in asthmatic patients. Nevertheless, a survey of a large number of patients may be useful in order to detect individuals at risk, since sensitivity to beta-blockade may vary between patients.