EFFECTS OF THE USE OF BETA-BLOCKERS ON CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) ASSOCIATED WITH CARDIOVASCULAR COMORBITIES: SYSTEMATIC REVIEW AND META-ANALYSIS.

Abstract

Cardiovascular comorbidity is common in individuals with Chronic obstructive pulmonary disease (COPD). These factor interferes in pharmacological treatment. The use of beta-blockers has been proposed for their known cardioprotective effects. However, there is a reluctance to use them due to adverse reactions and the risk of causing bronchospasm. To summarize existing evidences on the effects of beta-blocker use in COPD associated with cardiovascular comorbidities in relation to disease severity, exacerbation and mortality outcomes. EMBASE, Medline, Lilacs, Cochrane Library and Science Direct databases were used. Study selection and data extraction, observational studies were included that evaluated the effects of beta-blockers in individuals with COPD and cardiovascular comorbidities, and related disease severity, exacerbations, or mortality to outcomes. Studies that did not present important information about the sample and pharmacological treatment were excluded. Twenty studies were included. Relevance to patient care and clinical practice: The use of beta-blockers in individuals with COPD and cardiovascular disease caused positive effects on mortality and exacerbations outcomes compared with the results of individuals who did not use them. The severity of the disease caused a slight change in FEV1. The OR for mortality was 0.50 (95 % CI: 0.39-0.63; p-value <0.00001) and for exacerbations 0.76 (95 % CI: 0.62-0.92; p -value = 0.005), being favorable to the group that used beta-blockers. Further studies are needed to study the effect of using a specific beta-blocker in COPD associated with a specific cardiovascular comorbidity.