β-adrenoceptor blockers and pulmonary function in the general population: The Rotterdam Study

摘要

Aim β-adrenoceptor blockers have been used with caution in patients with obstructive lung diseases such as asthma or chronic obstructive pulmonary disease (COPD), due to the potentially increased airway reactivity and risk of bronchial obstruction. Cardioselective β-adrenoceptor blockers have a more beneficial profile than non-cardioselective β-adrenoceptor blockers and can be safely prescribed to patients with both cardiovascular disease and COPD. We hypothesized that cardioselective β-adrenoceptor blockers also affect pulmonary function. Methods This study was performed within the Rotterdam Study, a prospective population-based cohort study. Effects of cardioselective and non-cardioselective β-adrenoceptor blockers on pulmonary function were analysed using regression techniques with multivariable adjustment for potential confounders. Results Current use of non-cardioselective β-adrenoceptor blockers was significantly associated with a lower forced expiratory volume in 1 s (FEV1) of -198 ml (95% CI -301, -96), with a lower forced vital capacity (FVC) of -223 ml (95% CI -367, -79) and with a decreased FEV 1: FVC of -1.38% (95% CI -2.74, -0.13%). Current use of cardioselective β-adrenoceptor blockers was significantly associated with a lower FEV1 of -118 ml (95% CI -157, -78) and with a lower FVC of -167 ml (95% CI -222, -111), but did not affect FEV1: FVC. After exclusion of patients with COPD, asthma and heart failure the effects of cardioselective β-adrenoceptor blockers remained significant for FEV 1 (-142 ml [95% CI -189, -96]) and for FVC (-176 ml [95% CI -236, -117]). Conclusion In our study both non-cardioselective and cardioselective β-adrenoceptor blockers had a clinically relevant effect on both FEV 1 and FVC. In contrast to cardioselective β-adrenoceptor blockers, use of non-cardioselective β-adrenoceptor blockers was associated with a significantly lower FEV1: FVC.