Because cardiovascular morbidity and mortality are common in COPD, a practical question regarding management concerns whether to tailor therapy for the lung disease to accommodate cardiac concerns, or vice versa. Beta-adrenergic blocking agents provide a survival benefit in coronary artery disease so their use should not be limited to COPD. Furthermore, although use of short-acting bronchodilators as rescue agents may be called into question in the setting of active coronary artery disease, large trials that incorporate the use of long-acting beta agonists and include patients with coronary atherosclerosis provide a clear safety profile and indicate a trend toward survival benefit.
Reposted with permission from Decision Support in Medicine, LLC.