Comparative effects of celiprolol, propranolol, oxprenolol, and atenolol on respiratory function in hypertensive patients with chronic obstructive lung disease

Abstract

The aim of the study was to compare the pulmonary effects of four beta-blockers with different ancillary properties: propranolol (non-beta 1 selective without ISA), oxprenolol (non-beta 1 selective with ISA), atenolol (beta 1 selective), and celipropol (beta 1 selective with mild beta 2-agonist and alpha 2-antagonist activity) in hypertensive patients with chronic obstructive lung disease. Ten asthmatic patients, all males, aged 50-66 years were studied. Entry criteria were a) DBP greater than or equal to 95 mmHg and less than or equal to 115 mmHg; b) FEV1 less than 70% of the theoretical values; c) FEV1 increase of at least 20% after salbutamol inhalation (200 micrograms). After a 2-week washout period on placebo, each patient received propranolol (80 mg/day), oxprenolol (80 mg/day), atenolol (100 mg/day), and celiprolol (200 mg/day) for 1 week, according to a randomized, cross-over design. At the end of the washout and of each treatment period, airway function, assessed by FEV1, FVC, and FEV1%, was evaluated by spirometry both in the basal condition and after salbutamol inhalation. Unlike propranolol and oxprenolol, which significantly reduced FEV1 and inhibited the bronchodilator response to inhaled salbutamol, atenolol and celiprolol did not significantly affect respiratory function and did not antagonize salbutamol effects. Celiprolol more closely approached placebo in its respiratory effects than did atenolol, although the differences were not statistically significant.

Role of beta-blockers in patients with COPD: current perspective

“…In the short-term trials dating back to the 1980s and including COPD patients with reversible airway obstruction, a significant fall in FEV 1 after BB treatment was not observed [23][24][25]. However, in one study that explored the long-term effects of BBs, FEV 1 declined significantly over six months by approximately 200 ml [26].…”

Heart Failure and Chronic Obstructive Pulmonary Disease

“…Medical subject heading (MeSH) terms "respiratory tract diseases" and "adrenergic beta-antagonists" yielded 227 studies, 18 of which addressed the review objectives (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22). Key word searches "chronic obstructive lung disease" and "beta adrenergic receptor blocking agent" or "[beta-blocker name]" identified 2 further studies (23,24).…”

Comparative Effects of a Two-Week Treatment with Nebivolol and Nifedipine in Hypertensive Patients Suffering from COPD

“…This is not a surprise because most of the adverse pulmonary effects exerted by β-adrenoceptor-blocking drugs in patients with airway dysfunction are related to interference with β 2 -adrenoceptor-mediated bronchodilation [6]. Nevertheless, it has been established that no β-blocker is entirely safe in patients with COPD [14, 15, 16, 17, 18], although the cumulative evidence from two meta-analyses indicates that cardioselective β-blockers should not be withheld in patients with reactive airway disease or COPD [13, 19]. …”