Corrao Salvatore, Brunori Giuseppe, Lupo Umberto, Perticone Francesco
Dept of Internal Medicine, National Relevance and High Specialization Hospital Trust, ARNAS Civico Di Cristina Benfratelli, Palermo, Italy
Centre of Research for Effectiveness and Appropriateness in Medicine (CREAM), DiBiMIS, University of Palermo, Palermo, Italy.
Eur Respir Rev. 2017 Aug 9;26(145). doi: 10.1183/16000617.0123-2016. Print 2017 Sep 30.
Chronic obstructive pulmonary disease (COPD) is the most common chronic respiratory disease and its prevalence is increasing worldwide, in both industrialised and developing countries. Its prevalence is ∼5% in the general population and it is the fourth leading cause of death worldwide. COPD is strongly associated with cardiovascular diseases; in fact, ∼64% of people suffering from COPD are treated for a concomitant cardiovascular disease and approximately one in three COPD patients die as a consequence of cardiovascular diseases.Inhaled bronchodilators might have adverse cardiovascular effects, including ischaemic events and arrhythmias, and beta-blockers might adversely influence the respiratory symptoms and the response to bronchodilators. For these reasons, it is important to know the safety profiles and the possible interactions between these two classes of drug, in order to prescribe them with greater awareness.In this article, we review the literature about the epidemiology of COPD, its association with cardiovascular diseases, and the safety of concurrent use of inhaled bronchodilators and beta-blockers, as a tool for improving the approach to complex therapies in clinical practice.
慢性阻塞性肺疾病（COPD）是最常见的慢性呼吸道疾病，在全球范围内，包括工业化国家和发展中国家，其患病率都在上升。在普通人群中，其患病率约为5%，是全球第四大致死原因。COPD与心血管疾病密切相关；事实上，约64%的COPD患者同时患有心血管疾病并接受治疗，约三分之一的COPD患者死于心血管疾病。吸入性支气管扩张剂可能会产生不良心血管影响，包括缺血性事件和心律失常，而β受体阻滞剂可能会对呼吸道症状和对支气管扩张剂的反应产生不利影响。出于这些原因，了解这两类药物的安全性概况以及它们之间可能存在的相互作用非常重要，以便更明智地开具这些药物。在本文中，我们回顾了关于COPD流行病学、其与心血管疾病的关联以及吸入性支气管扩张剂和β受体阻滞剂联合使用安全性的文献，作为改善临床实践中复杂治疗方法的一种手段。
