Various beta-blockers with different pharmacokinetic profile are used in heart failure. There is no comparison of tolerability between beta blockers. This study aimed to investigate tolerability of bisoprolol and carvedilol in elderly patients with heart failure. In a randomized, double blind trial we found no difference in tolerability. Bisoprolol induced more pronounced heart rate reduction whereas carvedilol reduced pulmonary function tests. We conclude there is no difference in overall tolerability yet there were some differences between bisoprolol and carvedilol.
Heart failure and chronic obstructive pulmonary disease (COPD) frequently coexist and are associated with beta blocker under use. This study determined pulmonary function at baseline and final visit after 12 weeks. In patients with COPD bisoprolol and karvedilol did not induce significant changes in FEV1 (B: +69ml, -17ml to 155ml, p=0.11; C: –137ml –288ml to 15ml, p=0.08) but the difference between beta blockers was significant (200ml, 26ml to 373ml, p=0.03) Bisoprolol had a better pulmonary safety profile in elderly patients with HF.
Combination of chronic obstructive pulmonary disease (COPD) and heart failure (HF) is common yet it is unacceptably rarely recognized. Due to similar clinical manifestations comorbidity is frequently not considered and appropriate diagnostic tests are not performed. Despite clear evidence of cardioselective beta-blockade safety and tolerability in COPD patients, beta-blockers remain grossly underprescribed and underdosed. Routine spirometry and echocardiography in HF and COPD patients, respectively, is therefore warranted to improve current clinical practice.
COBISS.SI-ID: 27578841
Like chronic heart failure, chronic obstructive pulmonary disease (COPD) is an enormous public health problem in industrialized countries. Our aim was to determine the prevalence and clinical impact of COPD among patients hospitalized for heart failure in a community hospital serving a population of 125,000 people. : COPD is frequent among hospitalized patients with heart failure. Beta-blockers are largely underused, which is probably a major reason for the higher mortality observed in patients with concomitant chronic heart failure and COPD.
COBISS.SI-ID: 25697497
Chronic cardiopulmonary disease typically induces and maintains (over)activation of several phylogenetically old adaptational and defensive mechanisms. In chronic disease conditions, however, those mechanisms are kept activated for longer periods Landmark trials in chronic heart failure have provided robust evidence for prognostic benefit for neurohormonal antagonists. Retrospective and epidemiological data for their beneficial effect in chronic obstructive pulmonary disease begin to accumulate and new fields (e.g. cancer and stroke) could be pending in the future.
COBISS.SI-ID: 25697241