Could heart drugs benefit people with COPD?

Drugs commonly used for high blood pressure and heart disease may also help people with a lung condition called COPD, reports a new study. Researchers found that people taking these drugs, called beta-blockers, had fewer flare-ups of COPD and were less likely to die during the 10-year study than those who did not.

What do we know already?

COPD is short for chronic obstructive pulmonary disease. It’s a condition that affects your lungs, often leading to breathlessness and a cough that doesn’t go away. It’s also called emphysema or chronic bronchitis and is usually caused by smoking.

Treatments can help the symptoms of COPD, but there’s no cure for the disease, which gets worse over time. In the UK, more than 30,000 people die of COPD each year, and these numbers are rising.

Many people with COPD also have heart and circulation problems, such as heart disease and high blood pressure. Beta-blockers are a common treatment for heart problems, but doctors are often reluctant to give the drugs to people with COPD because of worries that beta-blockers may negatively affect the lungs. However, recent studies have suggested that beta-blockers are not only safe for most people with COPD but could possibly help their lungs work better.

To learn more, researchers gathered information on 2,230 people with COPD from a large database of health records in the Netherlands. They followed the patients from 1996 to 2006, tracking their use of beta-blockers and whether they had any flare-ups of COPD symptoms or died of any cause.

What does the new study say?

Researchers found that people taking beta-blockers were more likely to be alive at the end of the study than those not taking the drugs. In total, 27 percent of people taking beta-blockers died during the study, compared with 32 percent of those not using the drugs.

This isn’t entirely surprising, given the high rate of heart disease among people with COPD, and the beneficial effect that beta-blockers can have on the condition. However, researchers also found similar results among people who had not been diagnosed with heart disease but were taking beta-blockers mainly to keep their blood pressure in check.

More surprisingly, people taking beta-blockers were less likely to have their COPD symptoms flare-up. Overall, 43 percent of people taking beta-blockers had at least one flare-up during the study, compared with 49 percent of those not taking the drugs. This suggests that beta-blockers may actually help lung function rather than hinder it, although researchers don’t yet know how.

How reliable are the findings?

This study has several strengths. It was based on detailed health records from a government database, and it looked at a large group of people over many years. When working out the results, researchers took into account several factors that might have affected people’s risk of having COPD flare-ups or of dying, including their age, whether they smoked, whether they had heart disease, and what drugs they were taking for their COPD and heart or circulation problems. This makes the results more reliable.

Nonetheless, researchers can’t be certain that other factors weren’t responsible for the reduction in risk among people taking beta-blockers. For example, it’s possible that patients who were very ill were less likely to be offered beta-blockers, and this helped push the death rate higher among those not taking the drugs.

To be certain that beta-blockers do help people with COPD, researchers now need to do a study in which they randomly assign COPD patients to take either a beta-blocker or a dummy treatment, and then compare what happens to these groups over time.

Where does the study come from?

The study was conducted by university researchers in the Netherlands and was published in the Archives of Internal Medicine, a journal owned by the American Medical Association.

What does this mean for me?

If you have COPD, these findings provide some promising news. They support other research showing that most people with COPD can safely take beta-blockers for high blood pressure, heart disease, and related problems. And taking these medicines might also lower your chance of having COPD flare-ups and help you live longer, although we need more research to know for certain.

What should I do now?

Talk to your doctor if you are curious about whether beta-blockers might be right for you. Your doctor can tell you more about the potential benefits and risks, as these drugs can have side effects and aren’t suitable for everyone. You might mention this study as part of your discussion.

From:

Rutten FH, Zuithoff NPA, Hak E, et al. Beta-blockers may reduce mortality and risk of exacerbations in patients with chronic obstructive pulmonary disease. Archives of Internal Medicine. 2010; 170: 880-887.

To learn more, see our information on COPD, heart failure, and high blood pressure.

source: guardian.co.uk

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