Beta-blockers and health-related quality of life in patients with peripheral arterial disease and COPD

Yvette RBM van Gestel¹, Sanne E Hoeks¹, Don D Sin², Henk Stam³, Frans W Mertens³, Jeroen J Bax⁴, Ron T van Domburg⁵, Don Poldermans⁶

¹Department of Anesthesiology, Erasmus Medical Center, Rotterdam, The Netherlands; ²Department of Medicine, University of British Columbia and The James Hogg iCAPTURe Center, St. Paul’s Hospital, Vancouver, Canada; ³Department of Pulmonology, Erasmus Medical Center, Rotterdam, The Netherlands; ⁴Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands; ⁵Department of Cardiology, Erasmus Medical Center, Rotterdam, The Netherlands; ⁶Department of Vascular Surgery, Erasmus Medical Center, Rotterdam, The Netherlands

Background: Beta-blockers are frequently withheld in patients with cardiovascular disease who also have chronic obstructive pulmonary disease (COPD) because of concerns that they might provoke bronchospasm and cause deterioration in health status. Although beta1-selective beta-blockers are associated with reduced mortality in COPD patients, their effects on health status are unknown. The aim of this study was to investigate the relationship between beta-blockers and health-related quality of life (HRQOL) in patients with peripheral arterial disease and COPD.

Methods: Of the original cohort of 3371 vascular surgery patients, 1310 had COPD of whom 469 survived during long-term follow-up. These COPD patients were sent the Short Form-36 (SF-36) health-related quality of life questionnaire, which was completed and returned by 326 (70%) patients.

Results: No significant differences in any of the SF-36 domains were observed between COPD patients who did and did not use beta-blockers (p > 0.05 for all). Furthermore, beta-blockers were not associated with any impairment in HRQOL among patients with COPD.

Conclusion: Beta-blockers had no material impact on the HRQOL of patients with peripheral arterial disease who also had COPD. This suggests that beta-blockers can, in most circumstances, be administered to patients with COPD without impairment in HRQOL.

Keywords: beta-blockers, chronic obstructive pulmonary disease, vascular surgery, health-related quality of life