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Q In patients with chronic obstructive pulmonary disease (COPD), do cardioselective β blockers cause adverse respiratory effects?
Clinical impact ratings GP/FP/Primary care ★★★★★★★ IM/Ambulatory care ★★★★★☆☆ Cardiology ★★★★★★☆ Respirology ★★★★★★☆
Cochrane Central Register of Controlled Trials, Medline, EMBASE/Excerpta Medica, CINAHL, respiratory journals, meeting abstracts, and relevant references (up to May 2005).
Study selection and assessment
randomised, blinded, controlled trials (RCTs) in any language that evaluated cardioselective β blockers as a single dose or for an extended period in patients with COPD and reported change in FEV1 or respiratory symptoms. Administration of β2 agonists, either intravenously or by inhalation, after cardioselective β blockers or placebo, was also studied. 20 RCTs (all crossover trials) met the selection criteria. 11 trials (n = 131, mean age 53.8 y, 80% men) evaluated a single dose of …
For correspondence: Dr S Salpeter, Stanford University and Santa Clara Valley Medical Center, San Jose, CA, USA.
Source of funding: Garfield Weston Foundation UK.