It is not uncommon for the patients to present with two or more disease states at the same time. Thus, the management of such concomitant disease states may be pharmacologically challenging as it is, for example, in the treatment of the chronic obstructive pulmonary disease (COPD) and hypertension (HTN) with a compelling indication of the post-myocardial infarction (post-MI). COPD is a progressive respiratory condition characterized by the inadequate airflow which makes the breathing more difficult. COPD patients are commonly treated with the bronchodilators such as the beta-2 adrenergic agonists.1 The beta-2 agonists stimulate …show more content…
Cohort groups were comprised of the total of 121,956 COPD patients with the age range from 45 to 80-years old who were also receiving the BB treatment. Of the 15 studies, 5 studies included only COPD patients with concomitant coronary heart disease (CHD) including angina pectoris and MI and the other 3 studies evaluated only COPD patients with the heart failure (HF). The duration of the treatment among studied participants ranged from 1 year to 7.2 years.1 The researchers observed that the BB use was associated with the significantly lowered mortality risk (RR 0.72; 95% CI=0.63 to 0.83) and COPD exacerbation (RR 0.63; 95% CI=0.57 to 0.71); (p = 0.00001).1 The decrease in the mortality risk was even greater in coronary artery disease (CAD), (RR 0.64; 95% CI=0.54 to 0.76) and HF (RR 0.74; 95% CI=0.58 to 0.93).1 In COPD patients, the sympathetic nervous system (SNS) is more active and thus associated with the increased heart and respiratory rates.1 Moreover, patients with the concomitant CAD often present with the insufficiently controlled heart rate and recurrent angina episodes.1 Therefore, since the BB are known to protect against adrenergic activity of the SNS, the mortality benefits seen in this meta-analysis may be …show more content…
FEV1 is the important determinant of the respiratory health in COPD patients. The researchers found no significant effects on FEV1 whether the single dose therapy (change in FEV1, −5.28% [CI, −10.03% to −0.54%]) or continued therapy (change in FEV1, 1.07% [CI, −3.3% to 5.44%]) was initiated in the mild to moderate airway disease.2 Similar study analysis which evaluated FEV1 response in the patients with severe COPD, revealed no significant reduction of the airway