Beta-blockers are used to treat some heart conditions. Some beta-blockers may not be good for people with chronic obstructive pulmonary disease (COPD), but new research has found that certain beta-blockers may help people who have both COPD and heart disease.
People with chronic obstructive pulmonary disease (COPD) often have other health challenges, and cardiovascular diseases are among the most common. A COPD diagnosis has the potential to complicate the treatment of other conditions, though.
For years, experts have questioned the safety of using beta-blockers to treat cardiovascular disease in people who also have COPD. New evidence suggests this class of medications can be safe and can even help prevent some COPD exacerbations or complications.
In this article, you’ll learn what COPD is, what beta-blockers are used to treat, and what you need to know about the relationship between COPD and treatments for cardiovascular disease.
Beta-blockers are a group of medications that block the effects of stress hormones, or beta-adrenergic substances like epinephrine or adrenaline.
These medications are most often used to treat things like irregular heartbeats and high blood pressure. The end effect of beta-blockers is that the heart beats more slowly and regularly, increasing the strength of your heart and the blood that’s pumped with each beat.
Commonly prescribed beta-blockers include:
COPD is a group of diseases that impacts the lungs either by reducing your ability to switch out fresh oxygen with waste gases (emphysema) or by causing congestion and obstruction that limits airflow (chronic bronchitis).
Some form of COPD impacts an estimated 30 million Americans. While people with COPD face problems from this condition itself, there are also a number of other health issues that can develop alongside it.
With many shared risk factors like smoking and obesity, cardiovascular disease can be found in some form among many people with COPD. One study found that people with COPD were
The benefit of beta-blockers in people with COPD has been debated.
Questions for a doctor
If you’re prescribed beta-blockers and you have COPD, it’s important to understand why and what side effects to expect. Below are some questions you may want to ask a doctor before starting beta-blockers with COPD.
- Why is the beta-blocker being prescribed?
- Is this specific beta-blocker compatible with my COPD?
- What side effects should I expect from this beta-blocker?
- Are there any symptoms I should watch for that might require me to stop taking this medication?
- What types of complications warrant a phone call to a doctor’s office versus a visit to the emergency department?
Beta-blockers aren’t prescribed to treat COPD specifically. Many people with COPD also have some form of cardiovascular disease, and beta-blockers are used to treat those conditions. Medications with a similar name but a different function, called beta-agonists, are used to treat COPD.
While more research is needed, the following beta-blockers may have a lower risk for people with COPD:
There’s some evidence that the use of certain beta-blockers in people with COPD may help reduce inflammation and demand on cardiac tissue, resulting in lower mortality rates and fewer exacerbations.
However, more research is needed to determine which beta-blockers, if any, could offer the most benefit without other side effects or complications.
As rule, beta-blockers are associated with a reduction in lung function among people with COPD.
Use of specific beta-blockers, known as cardioprotective beta-blockers, are usually preferred for use in people with COPD when necessary because they reduce the chances of complications like COPD exacerbations and bronchospasms.
There’s also a concern that beta-blockers may reduce the effects of other important COPD medications, specifically beta-agonists.
Many of the complications or side effects of beta-blockers are somewhat expected outcomes of the medications, like a slower heart rate and decreased blood pressure. These effects can be more extreme or problematic in some people, though.
People who take beta-blockers most often list side effects like:
Less common side effects can include things like:
Always speak with a doctor before taking any medication. Beta-blockers are only available with a prescription. Never take someone else’s prescribed medications.
If a doctor or another healthcare professional prescribes you a beta-blocker and you have COPD, cardioselective beta-blockers may be preferred. But since this isn’t a Food and Drug Administration (FDA)-approved use for these medications, if prescribed for COPD, it would be considered an off-label use.
Examples of cardioselective beta-blockers include:
- acebutolol (Sectral)
- atenolol (Tenormin)
- betaxolol (Kerlone)
- bisoprolol (Zebeta)
- esmolol (Brevibloc)
- metoprolol (Lopressor, Toprol XL)
- nebivolol (Bystolic)
Non-cardioselective beta-blockers that may be associated with increased risks in people with COPD include:
- propranolol (Inderal LA)
Beta-blockers are used to treat heart conditions in which your heart has been weakened or beats irregularly. Beta-blockers slow your heart rate, allowing it to pump with greater force. Beta-blockers are usually prescribed:
- for chest pain (angina)
- for congestive heart failure
- for high blood pressure (hypertension)
- for an irregular heartbeat (arrhythmia)
- for postural tachycardia syndrome (POTS)
- to prevent heart attacks (myocardial infarction) in people who’ve already had a heart attack
Are there any other conditions that would make a healthcare professional hesitant to prescribe beta-blockers?
There are a few conditions for which there are assumed or absolute reasons not to take beta-blockers. These may include conditions like:
- peripheral vascular disease
- diabetes mellitus
- low heart rate (bradycardia)
- symptomatic low blood pressure (hypotension)
- atrioventricular heart block
Some of these are absolute reasons that you can’t take beta-blockers, and others may depend on the specific beta-blocker that’s being prescribed and why you need to take it. Talk with a doctor if you have any questions about your prescription medications.
There are some medical conditions that prevent you from taking beta-blockers. COPD has long been thought to be one of those, but newer research shows that there are some beta-blockers that can be safe for people with COPD.
If you have a heart condition that may be treated with beta-blockers, a doctor will discuss the risks versus benefits of these medications for you, especially if you have a condition like COPD.