Acute effects of low dose bisoprolol on lung function and blood pressure in COPD patients

Abstract

BACKGROUND AND OBJECTIVE: Recent observational data suggests that cardioselective β-blockers like bisoprolol are safe and beneficial for patients with chronic obstructive pulmonary disease (COPD). However, the acute effects of bisoprolol on lung and cardiovascular function in these patients is unclear, a gap that this study aimed to address. METHODS: This was a sub-analysis of pre-randomisation screening visit data from the ongoing Preventing Adverse Cardiac Events (PACE) in COPD randomised controlled trial. If all other eligibility criteria were met, participants were orally administered an unblinded 1.25 mg tablet of bisoprolol. Post-bronchodilator spirometry, heart rate and blood pressure were monitored at 0, 30 (cardiovascular parameters only), 60 and 120 min. For this sub-analysis, respiratory intolerance was defined as a decrease in forced expiratory volume in 1 min (FEV1)(L) ≥200 mL and ≥12% from the 0-minute FEV1(L) value; and cardiovascular intolerance was defined as systolic blood pressure (SBP) falling below 100 mmHg at 1 or 2 h. RESULTS: Of 359 consented participants, 292 conducted the test-dose procedure. Thirteen (4.5%) were respiratory intolerant and 6 (2.1%) were cardiovascular intolerant at 1 or 2 h. No participant was intolerant for both. There was no significant difference in FEV1 (L) or SBP at baseline At 120 min the intolerant group's mean FEV1 (L) had significantly decreased to 1.05 L (0.86–1.25; p<0.0001); the tolerant group experienced no change (1.10 L (1.05–1.14); p=0.33). CONCLUSION: The administration of 1.25 mg bisoprolol was acutely well tolerated in over 95% of COPD patients.