Asthma and beta-blockers

Abstract

In a randomized, blind crossover study in 14 hypertensive patients with asthma, involving placebo and chronically administered (3 weeks) equipotent beta1-blocking doses of atenolol 100 mg once daily and metoprolol 100 mg bid, atenolol and metoprolol produced a similar fall in blood pressure. Atenolol caused significantly (p less than 0.05) less bronchospasm in terms of fewer asthmatic attacks, more asthma-free days, less frequent sensations of moderate to very severe, wheeziness and less effect on the evening peak flow rate. It was concluded that, in patients with asthma who require beta blockade, atenolol is the preferred agent, co-prescribed with a beta2 stimulant.

Pharmacological modulation of β-adrenoceptor function in patients with coexisting chronic obstructive pulmonary disease and chronic heart failure

“…whether a β-blocker is β 1 -AR selective or β 1 -AR nonselective [67][68][69][70][71][72]. β 1 -blockade does not attenuate β 2 -agonist induced bronchodilation.…”

Comparative beta‐adrenoceptor blocking effects of propranolol, bisoprolol, atenolol, acebutolol and diacetolol on the human isolated bronchus.

“…There are, however, differences in the degree of selectivity of the cardioselective ,-adrenoceptor blockers since they displace to varying extents the bronchial dose-response curves to 32-adrenoceptor stimulants. In clinical studies, atenolol or bisoprolol appeared to be more selective than other compounds, such as acebutolol, metoprolol or oxprenolol (Greefhorst & van Herwaarden, 1982;Gribbin et al, 1981;Lammers et al, 1984;Lawrence et al, 1982;Macquin-Mavier et al, 1988;Perks et al, 1978;Ruffin et al, 1979;Tattersfield et al, 1984). Bronchial rings from a segmental bronchus were prepared and suspended in parallel in Krebs solution under an initial tension of 2.5 g. After 1.5 h of equilibration, the resting tension was between 1 and 2 g. Tensions were measured isometrically with strain gauges, amplifiers and .O.S..-Moise 2 recorder system (Celaster, Celle l'Evescault, 86600 Lusignan, France) (Advenier et al, 1986).…”

Beta-Blockers after Myocardial Infarction: Do Benefits Ever Outweigh Risks in Asthma?

“…Metoprolol has been studied in varying doses in patients with asthma in at least 16 trials [17, 18, 26, 27, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40]. In virtually all of these studies, metoprolol caused some decrease in pulmonary function.…”

“…Numerous clinical trials have examined the effect of atenolol in patients with asthma [18, 36, 42, 43, 44, 45, 46, 47, 48, 49]. Atenolol at low doses (e.g.…”

“…Atenolol at low doses (e.g. 50 mg) appears to be the safest, or at least one of the safest, β 1 -blockers for use in patients with asthma [18, 36, 42, 43, 44]. In a double-blind, randomized, placebo-controlled, crossover study, Ellis et al [42]evaluated 10 patients with reversible airway obstruction who received on different days the following five treatments: atenolol (50, 100 and 200 mg), propranolol 40 mg, or placebo.…”