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Chronic obstructive pulmonary disease (COPD) is currently recognised as an inflammatory disease associated with significant extrapulmonary effects and important comorbidities, including ischaemic heart disease and heart failure.1 Despite ample evidence of the benefits of β-blockers in hypertension, ischaemic heart disease and congestive heart failure, use of β-blockers is >50% lower in heart failure patients with than without COPD,2 probably because of concern regarding the possibility of bronchospasm provoked by β-blockers in patients with underlying obstructive lung disease, despite evidence to the contrary.3 In view of the compelling evidence demonstrating beneficial effects of β-blockers in cardiovascular disease (CVD), including improved …
Competing interests None.