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Effect of β-Blockers on Cardiac and Pulmonary Events and Death in Older Adults With Cardiovascular Disease and Chronic Obstructive Pulmonary Disease

Bibliographic Data

ID9099870
AuthorsDavid S H Lee (Oregon Health & Science University, corresponding author), Sheila Markwardt (0000-0002-4929-4359, Oregon State University, corresponding author), Gail J McAvay, GAIL MCAVAY (0000-0002-1442-6294, Yale University), Cary P Gross (0000-0002-4974-935X, Yale University), Leah M Goeres (Oregon Health & Science University, corresponding author), Ling Han (0000-0002-3088-0374, Yale University), Peter Peduzzi (0000-0002-7634-6804, Yale University), Haiqun Lin (0000-0002-3114-9671, Yale University), John A Dodson (0000-0003-0163-3013, Yale University), Mary E Tinetti (0000-0003-0940-9702, Yale University)
Year2014
Volume52
IssueSupplement 2
PagesS45-S51
Publication date2014-03-01
Open AccessNo
TypeARTICLE
VenueMedical Care (JOURNAL)
Journal identifiersISSN: 0025-7079 • E-ISSN: 1537-1948
PublisherOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/mlr.0000000000000035
PMID24561758
PMCIDPMC4050644
OpenAlexW1980805424
LanguageEN
References cited15

CONTEXT: In older adults with multiple conditions, medications may not impart the same benefits seen in patients who are younger or without multimorbidity. Furthermore, medications given for one condition may adversely affect other outcomes. β-Blocker use with coexisting cardiovascular disease (CVD) and chronic obstructive pulmonary disease (COPD) is such a situation. OBJECTIVE: To determine the effect of β-blocker use on cardiac and pulmonary outcomes and mortality in older adults with coexisting COPD and CVD. DESIGN, SETTING, PARTICIPANTS: The study included 1062 participants who were members of the 2004-2007 Medicare Current Beneficiary Survey cohorts, a nationally representative sample of Medicare beneficiaries. Study criteria included age over 65 years plus coexisting CVD and COPD/asthma. Follow-up occurred through 2009. We determined the association between β-blocker use and the outcomes with propensity score-adjusted and covariate-adjusted Cox proportional hazards. MAIN OUTCOME MEASURES: The 3 outcomes were major cardiac events, pulmonary events, and all-cause mortality. RESULTS: Half of the participants used β-blockers. During follow-up, 179 participants experienced a major cardiac event; 389 participants experienced a major pulmonary event; and 255 participants died. Each participant could have experienced any ≥1 of these events. The hazard ratio for β-blocker use was 1.18 [95% confidence interval (CI), 0.85-1.62] for cardiac events, 0.91 (95% CI, 0.73-1.12) for pulmonary events, and 0.87 (95% CI, 0.67-1.13) for death. CONCLUSION: In this population of older adults, β-blockers did not seem to affect occurrence of cardiac or pulmonary events or death in those with CVD and COPD

Asthma · Cardiology · Confidence interval · COPD · Hazard ratio · Physical therapy · Population · Proportional hazards model · Cardiac, Anesthesia and Surgical Outcomes · Chronic Obstructive Pulmonary Disease (COPD) Research · Heart Failure Treatment and Management · Internal Medicine · Medicine

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Highly citedNo

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