Dos Santos Natasha Cordeiro, Camelier Aquiles Assunção, Menezes Anne Karine, de Almeida Victor Durier Cavalcanti, Maciel Roberto Rodrigues Bandeira Tosta, Camelier Fernanda Warken Rosa
Department of Life Sciences, State University of Bahia, Salvador, Brazil.
Tuberc Respir Dis (Seoul). 2024 Jul;87(3):261-281. doi: 10.4046/trd.2024.0013. Epub 2024 Apr 4.
Cardiovascular comorbidity is common in individuals with chronic obstructive pulmonary disease (COPD). This factor interferes with pharmacological treatment. The use of β-blockers has been proposed for their known cardioprotective effects. However, due to their adverse reactions, and the risk of causing bronchospasm, there is reluctance to use them. To summarize existing evidence on the effects of β-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. Observational studies that evaluated the effects of β-blockers on individuals with COPD and cardiovascular comorbidities, and related disease severity, exacerbations, or mortality outcomes were included. 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 β-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 forced expiratory volume in 1 second. The odds ratio for mortality was 0.50 (95% confidence interval [CI], 0.39 to 0.63; p<0.00001), and for exacerbations, 0.76 (95% CI, 0.62 to 0.92; p=0.005), being favorable to the group that used β-blockers. Further studies are needed to study the effect of using a specific β-blocker in COPD associated with a specific cardiovascular comorbidity.
心血管合并症在慢性阻塞性肺疾病（COPD）患者中很常见。这一因素会干扰药物治疗。由于已知β受体阻滞剂具有心脏保护作用，因此有人提议使用该药物。然而，由于其不良反应以及引起支气管痉挛的风险，人们不愿使用它们。总结现有证据，以探讨β受体阻滞剂用于合并心血管疾病的COPD患者时，对疾病严重程度、急性加重和死亡率结局的影响。我们使用了EMBASE、Medline、Lilacs、Cochrane图书馆和Science Direct数据库。纳入了评估β受体阻滞剂对合并心血管疾病的COPD患者的影响以及相关疾病严重程度、急性加重或死亡率结局的观察性研究。未提供有关样本和药物治疗重要信息的研究被排除。共纳入20项研究。与患者护理和临床实践的相关性：与未使用β受体阻滞剂的患者相比，在合并心血管疾病的COPD患者中使用β受体阻滞剂对死亡率和急性加重结局产生了积极影响。疾病严重程度导致一秒用力呼气量略有变化。死亡率的优势比为0.50（95%置信区间[CI]，0.39至0.63；p<0.00001），急性加重的优势比为0.76（95%CI，0.62至0.92；p=0.005），对使用β受体阻滞剂的组有利。需要进一步研究特定β受体阻滞剂用于合并特定心血管疾病的COPD患者的效果。
