Nielsen Anne Orholm, Pedersen Lars, Sode Birgitte Fischer, Dahl Morten
Department of Clinical Biochemistry, Zealand University Hospital, Lykkebækvej 1, 4600 Køge, Denmark.
Department of Clinical Epidemiology, Aarhus University Hospital, Olof Palmes Allé 43-45, 8200 Aarhus N, Denmark.
EClinicalMedicine. 2019 Jan 29;7:21-26. doi: 10.1016/j.eclinm.2019.01.004. eCollection 2019 Jan.
The possible association between β-adrenoceptor antagonists (β-blockers) and risk of COPD is controversial. The objective of the present study was to test whether β-blocker use is associated with susceptibility to the disease.
A total of 301,542 new users of β-blockers and 1,000,633 new users of any other antihypertensive drugs aged 30-90 years without any history of COPD hospitalizations were included in the present study and followed in the Danish National Patient Registry for incident admissions for COPD and COPD death between 1995 and 2015. Multiple adjusted cox regression models were used to examine the association between use of β-blockers and COPD hospitalization. Additionally, subgroup analyses based on underlying diseases at baseline or duration of treatment were performed.
People treated with β-blockers continuously for more than 6 months had a lower risk of COPD hospitalization during follow-up compared to people treated with any other antihypertensive drugs (adjusted hazard ratio [HR] 0·80, 95% CI 0·79-0·82). Risk of COPD hospitalization was lowered in the groups treated with β-blockers among patients with ischemic heart disease (0·72, 0·69-0·75), cardiac arrhythmias (0·76, 0·72-0·80), asthma (0·69, 0·61-0·79), hypertension (0·91, 0·86-0·96), and diseases of the pulmonary circulation (pulmonary embolism and cor pulmonale) (0·72, 0·59-0·87). All-cause mortality as well as risk of COPD death during follow-up was lower in the group treated with β-blockers compared to the group treated with any other antihypertensive drugs (0·56, 0·53-0·59).
Treatment with β-blockers seems to reduce risk of COPD hospitalization and mortality compared to treatment with any other antihypertensive drugs.
The Danish Council for Independent Research in Denmark (grant no. 4183-00569B), The Research Foundation of Health Science in Region Zealand (grant no. RSSF2017000661 and no. 15-000342), The Research Foundation of Medical Science (A.P. Møller Foundation, grant no. 16-68), The Research Foundation in memory of King Christian 10th (grant no. 142/2017), Aase & Ejnar Danielsen's Research Foundation (grant no. 10-001946), and Lundbeck Foundation (grant no. R252-2017-1690).
β-肾上腺素能受体拮抗剂（β受体阻滞剂）与慢性阻塞性肺疾病（COPD）风险之间的潜在关联存在争议。本研究的目的是检验使用β受体阻滞剂是否与该疾病的易感性相关。
本研究纳入了301542名年龄在30 - 90岁、无COPD住院史的β受体阻滞剂新使用者以及1000633名其他任何抗高血压药物新使用者，并在丹麦国家患者登记处对其进行随访，以了解1995年至2015年间因COPD入院和COPD死亡情况。使用多因素调整的Cox回归模型来检验β受体阻滞剂的使用与COPD住院之间的关联。此外，还根据基线时的基础疾病或治疗持续时间进行了亚组分析。
与使用其他任何抗高血压药物的人相比，连续使用β受体阻滞剂超过6个月的人在随访期间COPD住院风险较低（调整后风险比[HR]为0.80，95%置信区间为0.79 - 0.82）。在患有缺血性心脏病（0.72，0.69 - 0.75）、心律失常（0.76，0.72 - 0.80）、哮喘（0.69，0.61 - 0.79）、高血压（0.91，0.86 - 0.96）以及肺循环疾病（肺栓塞和肺心病）（0.72，0.59 - 0.87）的患者中，使用β受体阻滞剂治疗的组COPD住院风险降低。与使用其他任何抗高血压药物的组相比，使用β受体阻滞剂治疗的组在随访期间的全因死亡率以及COPD死亡风险较低（0.56，0.53 - 0.59）。
与使用其他任何抗高血压药物相比，使用β受体阻滞剂治疗似乎可降低COPD住院风险和死亡率。
丹麦独立研究理事会（资助编号：4183 - 00569B）、西兰岛地区健康科学研究基金会（资助编号：RSSF2017000661和15 - 000342）、医学科学研究基金会（A.P. 穆勒基金会，资助编号：16 - 68）、纪念克里斯蒂安十世国王研究基金会（资助编号：142/2017）、奥瑟与埃伊纳·丹尼尔森研究基金会（资助编号：10 - 001946）以及伦德贝克基金会（资助编号：R252 - 2017 - 1690）。
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