Retrospectively looking at a database of 5,977 COPD patients’ hospital admissions (TARDIS), pharmacy data, and death records in Scotland, Short et al found an overall 22% lower mortality in those taking beta blockers (88% were cardioselective BBs). The benefit was seen equally in those also taking long-acting beta agonists or antimuscarinics. For those 2,712 patients with serial spirometry results available, adding a BB did not cause FEV1 to fall faster than expected.BMJ 2011;342:d2549.
Beta blockers are probably unfairly maligned as exacerbation-causers in COPD. Although experimental studies have suggested deleterious effects on lung function, a 2005 Cochrane review of 11 randomized trials contradicted this and concluded cardioselective BBs do not cause respiratory exacerbations or declines in FEV1.