BACKGROUND: Beta-blocker therapy has mortality benefit in @entity1 with @entity101 , @entity712 and @entity453 , as well as during the perioperative period. These drugs have traditionally been considered contraindicated in @entity1 with reversible @entity1030 . OBJECTIVES: To assess the effect of cardioselective @entity8652 -blockers on respiratory function of @entity1 with reversible @entity1030 . Reversible @entity1030 was defined as @entity565 or @entity1030 with a reversible obstructive component. SEARCH STRATEGY: A comprehensive search of EMBASE, MEDLINE and CINAHL was performed using the Cochrane Airways Group registry to identify randomized blinded placebo-controlled trials from 1966 to May 2001. The search was completed using the terms: @entity565 *, @entity6587 *, respiratory sounds*, wheez*, @entity3885 * or obstructive @entity1030 *, and adrenergic antagonist*, sympatholytic* or adrenergic receptor block*. We did not exclude trials on the basis of language. SELECTION CRITERIA: Randomized, blinded, placebo-controlled trials of single dose or longer duration that studied the effects of cardioselective @entity8652 -blockers on the forced expiratory volume in 1 second (FEV1), symptoms and use of short-acting inhaled @entity2263 -agonists, in @entity1 with reversible @entity1030 . Reversible @entity1030 was documented by response to @entity2710 challenge, by an increase in FEV1 of at least 15% to @entity2263 -agonist administration, or the presence of @entity565 as defined by the American @entity1514 Society. DATA COLLECTION AND ANALYSIS: Two independent reviewers extracted data from the selected articles, reconciling differences by consensus. Cardioselective @entity8652 -blockers were divided into 2 groups, those with or without intrinsic sympathomimetic activity (ISA). Two interventions studied were the administration of @entity8652 -blocker, given either as a single dose or for longer duration, and the use of @entity2263 -agonist given after the study drug. MAIN RESULTS: Nineteen studies for single-dose treatment and 10 for treatment of longer duration met selection criteria. The @entity1 had mild-moderate @entity1224 . For cardioselective @entity8652 -blockers taken as a group, administration of a single dose was associated with a 7.98% (CI, 6.19 to 9.77%) reduction in FEV1, but with a 13.16% (CI, 10.76 to 15.56%) increase in @entity2263 -agonist response, as compared to placebo. There was no increase in symptoms. After treatment lasting a few days to a few weeks, there was no decrement in FEV1 compared to placebo and no increase in symptoms or inhaler use. Regular use of cardioselective @entity8652 -blockers without ISA produced a 13.13% (CI, 5.97 to 20.30) increase in @entity2263 -agonist response compared to placebo, a response not seen with @entity8652 -blockers containing ISA (-0.60% [CI, -11.7 to +10.5%]). REVIEWER'S CONCLUSIONS: Cardioselective @entity8652 -blockers, given to @entity1 with mild-moderate reversible @entity1030 , do not produce clinically significant adverse respiratory effects in the short term. It is not possible to comment on their effects in @entity1 with more severe or less reversible disease, or on their effect on the frequency or severity of acute exacerbations. Given their demonstrated benefit in conditions such as @entity712 , @entity453 and @entity101 , cardioselective @entity8652 -blockers should not be withheld from @entity1 with mild-moderate reversible @entity1030 .

Cardioselective beta-blockers for reversible XXXX .

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity712 :: ('MESH:D006333', 'Disease') :: ['heart failure'] @entity101 :: ('MESH:D006973', 'Disease') :: ['hypertension'] @entity8652 :: ('3779', 'Gene') :: ['beta1'] @entity565 :: ('MESH:D001249', 'Disease') :: ['asthma'] @entity3885 :: ('MESH:D008173', 'Disease') :: ['obstructive lung disease'] @entity1514 :: ('MESH:D013896', 'Disease') :: ['Thoracic'] @entity1030 :: ('MESH:D029424', 'Disease') :: ['chronic obstructive pulmonary disease', 'airway disease'] @entity2263 :: ('10242', 'Gene') :: ['beta2'] @entity453 :: ('MESH:D003324', 'Disease') :: ['coronary artery disease'] @entity6587 :: ('MESH:D016535', 'Disease') :: ['bronchial hyperreactivity'] @entity2710 :: ('MESH:D016210', 'Chemical') :: ['methacholine'] @entity1224 :: ('MESH:D000402', 'Disease') :: ['airways obstruction']
@entity1030 :: (MESH:D029424,Disease) :: ['airway disease']
