[Administration of cardioselective beta-adrenoblockers in patients with arterial hypertension and/or ischemic heart disease associated with bronchoobstructive syndrome].
OBJECTIVE
To assess efficacy and safety of selective beta-adrenoblockers (BAB) metoprolol succinate and nebivolol in patients with arterial hypertension (AH) and/or IHD associated with bronchoobstructive syndrome (BOS).


METHODS
Fifty patients suffering from AH and/or IHD associated with BOS in chronic obstructive pulmonary disease (COPD) and/or bronchial asthma (BA) of any severity in remission received BAB. Safety of BAB was evaluated by dynamics of respiratory symptoms and bronchial patency. An antihypertensive effect of BAB was assessed by the data of 24-h monitoring of BP, an antianginal one--by dynamics of clinical symptoms, amount of nitrates taken and exercise tolerance (6-min walk). The results of Holter ECG monitoring and an antiarrhythmic effect of BAB were also studied. RESULTS; Metoprolol succinate and nebivolol did not deteriorate bronchial patency (baseline FEV1--81.08 +/- 22.57%, at the end of the study--84.58 +/- 23.72% and 71.12 +/- 19.95, 73.19 +/- 21.70, respectively) in COPD and/or BA. Both drugs showed high antihypertensive efficacy as monotherapy and in combined therapy. Anginal attacks severity and frequency reduced significantly. The need in nitrosorbide fell noticeably, exercise tolerance increased significantly. Metoprolol succinate and nebivolol have a good anti-arrythmic effect.


CONCLUSIONS
Metoprolol succinate and nebivolol are safe in patients with bronchoobstructive syndrome and AH and/or IHD in the presence of cardiovascular indications; these drugs can be used in patients with severe COPD and BA as well as their exacerbations unrelated to administration of beta-adrenoblocker.
Ovcharenko
S I
SI
Litvinova
I V
IV
Mikolkin
V I
VI
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D001249:Asthma / Q000453:epidemiology; D001578:Benzopyrans / Q000627:therapeutic use*; D015897:Comorbidity; D004334:Drug Administration Schedule; D004983:Ethanolamines / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000453:epidemiology*; D008297:Male; D008790:Metoprolol / Q000627:therapeutic use*; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000188:drug therapy* / Q000453:epidemiology*; D000068577:Nebivolol; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology*; D012074:Remission Induction; D012720:Severity of Illness Index
D000319:Adrenergic beta-Antagonists; D001578:Benzopyrans; D004983:Ethanolamines; D000068577:Nebivolol; D008790:Metoprolol