Cardiovascular disease
Patients with COPD are at increased risk of cardiovascular disease. Diagnosing cardiovascular disease in COPD is complicated by the similarity in presentation, which in both cases can include breathlessness, fatigue and chest discomfort.
Beta-blocker therapy is commonly used for cardiovascular disease. In a 2019 randomised placebo-controlled trial of patients with COPD, beta-blocker therapy increased the incidence of severe and very severe exacerbations (requiring hospitalisation or intubation respectively), and possibly increased mortality1. Patients with heart failure with reduced ejection fraction (HFrEF), or with a myocardial infarction within the last 3 years, were excluded from the trial—beta-blocker therapy has proven mortality benefits in these patients and should not be withheld on the grounds of coexisting COPD.