Objective: To assess the effect of cardioselective β-blockers on pulmonary function in patients with chronic obstructive pulmonary disease (COPD).
Methods: The Embase and MEDLINE™ databases and the Cochrane Controlled Trials Register were searched comprehensively to identify all relevant clinical trials in humans published between January 1966 and May 2011. Randomized, blinded, placebo-controlled trials that studied the effects of cardioselective β-blockers on the forced expiratory volume in 1 s (FEV(1)) and the responsiveness of the FEV(1) to β-agonist administration in patients with COPD were included in the analysis.
Results: Five studies were identified: four of these assessed both cardioselective and nonselective β-blockers; one assessed only cardioselective β-blockers. The FEV(1) was shown to decrease by 0.14 l with nonselective β-blockers and by 0.03 l with cardioselective β-blockers. The responsiveness of the FEV(1) to β-agonist administration decreased significantly by 13.42% after nonselective β-blockers, but did not change significantly after cardioselective β-blocker administration.
Conclusion: This metaanalysis suggests that the use of β-blockers, especially cardioselective β-blockers, should not be contraindicated in patients with COPD.