PURPOSE: To assess the association between the type of antihypertensive medication and all-cause mortality among patients with chronic obstructive pulmonary disease (COPD). METHODS: The cohort comprised 1966 patients (mean [+/- SD] age, 65.8 +/- 10.7 years) enrolled in general internal medicine clinics at seven Veterans Affairs medical centers between December 1996 and October 1999. Patients had a diagnosis of both COPD and hypertension and were receiving single-agent antihypertensive therapy. RESULTS: Compared with calcium channel blockers, beta-blockers were associated with a decrease in mortality from any cause after adjusting for propensity for having been prescribed a beta-blocker (hazard ratio = 0.57; 95% confidence interval: 0.33 to 0.89). The association was similar when beta-blockers were compared with all other antihypertensive medications, and the decreased risk of mortality was apparent among patients with pre-existing cardiac disease. Restriction of analyses to long-acting calcium channel blockers or to patients who used beta-agonists did not affect the point estimates. Exposure to the remaining classes of antihypertensive agents was not associated with mortality. CONCLUSION: Beta-blockers may have beneficial effects in patients who have COPD, pre-existing cardiac disease, and hypertension. Beta-blockers may not be contraindicated among patients with COPD.
PURPOSE: To assess the association between the type of antihypertensive medication and all-cause mortality among patients with chronic obstructive pulmonary disease (COPD). METHODS: The cohort comprised 1966 patients (mean [+/- SD] age, 65.8 +/- 10.7 years) enrolled in general internal medicine clinics at seven Veterans Affairs medical centers between December 1996 and October 1999. Patients had a diagnosis of both COPD and hypertension and were receiving single-agent antihypertensive therapy. RESULTS: Compared with calcium channel blockers, beta-blockers were associated with a decrease in mortality from any cause after adjusting for propensity for having been prescribed a beta-blocker (hazard ratio = 0.57; 95% confidence interval: 0.33 to 0.89). The association was similar when beta-blockers were compared with all other antihypertensive medications, and the decreased risk of mortality was apparent among patients with pre-existing cardiac disease. Restriction of analyses to long-acting calcium channel blockers or to patients who used beta-agonists did not affect the point estimates. Exposure to the remaining classes of antihypertensive agents was not associated with mortality. CONCLUSION: Beta-blockers may have beneficial effects in patients who have COPD, pre-existing cardiac disease, and hypertension. Beta-blockers may not be contraindicated among patients with COPD.
Authors: Sergio E Chiarella; Saul Soberanes; Daniela Urich; Luisa Morales-Nebreda; Recep Nigdelioglu; David Green; James B Young; Angel Gonzalez; Carmen Rosario; Alexander V Misharin; Andrew J Ghio; Richard G Wunderink; Helen K Donnelly; Kathryn A Radigan; Harris Perlman; Navdeep S Chandel; G R Scott Budinger; Gökhan M Mutlu Journal: J Clin Invest Date: 2014-05-27 Impact factor: 14.808
Authors: Surya P Bhatt; James M Wells; Gregory L Kinney; George R Washko; Matthew Budoff; Young-Il Kim; William C Bailey; Hrudaya Nath; John E Hokanson; Edwin K Silverman; James Crapo; Mark T Dransfield Journal: Thorax Date: 2015-08-17 Impact factor: 9.139
Authors: Mihaela S Stefan; Michael B Rothberg; Aruna Priya; Penelope S Pekow; David H Au; Peter K Lindenauer Journal: Thorax Date: 2012-08-31 Impact factor: 9.139
Authors: Robert M Reed; Michael Eberlein; Reda E Girgis; Salman Hashmi; Aldo Iacono; Steven Jones; Giora Netzer; Steven Scharf Journal: Am J Med Date: 2012-09-06 Impact factor: 4.965