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Revista Portuguesa de Medicina Geral e Familiar

Print version ISSN 2182-5173

Abstract

COELHO, Mariana Baltazar  and  FERREIRA, Manuel Branco. Beta-blockers and asthma. Rev Port Med Geral Fam [online]. 2021, vol.37, n.2, pp.146-157.  Epub Apr 30, 2021. ISSN 2182-5173.  https://doi.org/10.32385/rpmgf.v37i2.12847.

Background:

Asthmatic patients may have some conditions for which the use of beta-blockers is required. Therapy with these drugs is used in several diseases and it is widely used in clinical practice, especially in primary care. This means that it is important to clarify possible contraindications to its use in subjects with asthma.

Objectives:

Evaluating the effects of cardioselective and non-selective beta-blockers in asthmatic patients: changes in the pulmonary function tests; acute exacerbations of the disease and its symptomatology; the frequency that they need to use rescue drugs; the need to use an emergency department and frequency of hospitalizations related to the adverse effects caused by these drugs.

Methods:

This systematic review included articles searched in PubMed electronic database. The search term used was: asthma AND beta-blockers.

Results:

There were 151 articles identified, from which 49 were selected after reading the titles and abstracts. Of these, after reading the complete article and applying the inclusion criteria, 30 articles were selected. Atenolol and propranolol were the most frequently studied beta-blockers. Two randomized clinical trials and one cohort were about topical beta-blockers; 22 randomized clinical trials studied oral or intravenous beta-blockers. Five cohorts were also discussed.

Conclusion:

Beta-blockers in mild to moderate asthma can be used but always with monitoring of pulmonary function and symptoms of the patient. We could not demonstrate a preference for drug selectivity. Topical ocular beta-blockers in asthma can have detrimental effects by reducing FEV1 and increasing asthma exacerbations. We cannot recommend the use of beta-blockers as a treatment for asthma since we still have few studies on this topic.

Keywords : Asthma; Beta-blocker; FEV1; Bronchoconstriction; Wheezing.

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