Use of beta blockers in patients with asthma and chronic obstructive pulmonary disease

Abstract

Introduction. Beta blockers play an essential role in the treatment of cardiovascular diseases, but also various other endocrinological, gastroenterological, ophthalmological and neurological disorders. The most important effects of beta blockers are a reduction in myocardial oxygen consumption and inhibition of renin secretion. Beta blockers are divided into three generations according to their selectivity - non-selective, cardioselective and vasodilating beta blockers. Beta blockers and obstructive pulmonary diseases. Patients with obstructive pulmonary diseases are significantly more likely to develop cardiovascular diseases compared to general population, largely due to common risk factors such as smoking, systemic inflammation, age, and genetic predisposition. The use of nonselective beta blockers carries a great risk for patients with obstructive pulmonary diseases, while cardioselective beta blockers can be used more extensively. Reversible airway obstruction is predominantly present in asthma, so that the adverse effects of beta blockers on the airways are significantly more pronounced in asthma compared to chronic obstructive pulmonary disease. Conclusion. In both asthma and chronic obstructive pulmonary disease, the use of highly cardioselective beta blockers such as bisoprolol and nebivolol is preferred. The use of beta blockers in patients with asthma requires great caution due to the possibility of bronchial obstruction, while in patients with chronic obstructive pulmonary disease they are somewhat safer. Patients must be closely monitored by a physician, with special attention focused on clinical signs of airway obstruction such as wheezing, shortness of breath, and prolonged expiration.