title: β-Adrenoceptor blockers and pulmonary function in the general population: the Rotterdam Study.
abstract: OBJECTIVE
  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 FEV1  : 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 FEV1 (-142 ml [95% CI -189, -96]) and for FVC (-176 ml [95% CI -236, -117]).
  
  
  CONCLUSIONS
  In our study both non-cardioselective and cardioselective β-adrenoceptor blockers had a clinically relevant effect on both FEV1 and FVC. In contrast to cardioselective β-adrenoceptor blockers, use of non-cardioselective β-adrenoceptor blockers was associated with a significantly lower FEV1: FVC.
authors.affiliation: Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands; Inspectorate of Health Care, The Hague, The Netherlands.
authors.forename: Daan W
authors.initials: DW
authors.lastname: Loth
authors.forename: Guy G
authors.initials: GG
authors.lastname: Brusselle
authors.forename: Lies
authors.initials: L
authors.lastname: Lahousse
authors.forename: Albert
authors.initials: A
authors.lastname: Hofman
authors.forename: Hubert G M
authors.initials: HG
authors.lastname: Leufkens
authors.forename: Bruno H
authors.initials: BH
authors.lastname: Stricker
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000009:adverse effects* / Q000494:pharmacology; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D005541:Forced Expiratory Volume / Q000187:drug effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D014797:Vital Capacity / Q000187:drug effects*
chemical_list: D000319:Adrenergic beta-Antagonists
keywords: FEV1 : FVC; FVC; epidemiology; population studies; spirometry; β-adrenoceptor blockers FEV1