title: [Differences among beta-blockers for the treatment of patients with heart failure and chronic obstructive pulmonary disease].
abstract: Although current guidelines support the use of beta-blockers (BB) in all patients with symptomatic heart failure (HF) and left ventricular systolic dysfunction, unless contraindicated or not tolerated, they are still underused, especially in patients with chronic obstructive pulmonary disease (COPD). BB are associated with a potential risk for lung function decline and airway hyperresponsiveness, and reluctance still exists to prescribe these agents in COPD patients. However, a large body of evidence indicates that these patients tolerate well selective beta-blockade, and BB should not be denied to HF patients with concomitant COPD. Current guidelines and recent reports recommend the use of selective BB in all patients with stable COPD and irreversible airway obstruction, to be administered at the lowest dose and at a low titration rate. Close monitoring of lung function by spirometry is strongly encouraged to guide and enhance a safe BB use in everyday practice. Pneumologists and cardiologists should develop shared strategies with the aim to implement selective BB therapy in clinical practice and improve the prognosis of both HF and COPD.
authors: U.O. di Cardiologia, Aziensa Istituti Ospitalieri, Cremona. giditano@tin.it
authors: Giuseppe
authors: G
authors: Di Tano
authors: Silvia
authors: S
authors: Frattini
authors: Salvatore
authors: S
authors: Pirelli
mesh_terms: D058668:Adrenergic alpha-1 Receptor Antagonists / Q000008:administration & dosage* / Q000009:adverse effects; D058671:Adrenergic beta-1 Receptor Antagonists / Q000008:administration & dosage* / Q000009:adverse effects; D019317:Evidence-Based Medicine; D006333:Heart Failure / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D012129:Respiratory Function Tests; D012720:Severity of Illness Index; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000188:drug therapy
chemical_list: D058668:Adrenergic alpha-1 Receptor Antagonists; D058671:Adrenergic beta-1 Receptor Antagonists