The use of beta-blockers in patients with chronic obstructive pulmonary disease and chronic heart failure in real clinical practice
Objective: to reveal the features of the use of beta-blockers (BB) in patients with chronic obstructive pulmonary disease (COPD) and chronic heart failure (CHF) in real clinical practice.Materials and methods: the study included 90 patients with COPD and CHF, and 41 patients with CHF of ischemic genesis without COPD.Results: patients with COPD and CHF were significantly less likely to receive beta-blockers (BB) compared with patients with CHF. Of the BB patients with COPD and CHF were primarily prescribed bisoprolol, its average dose was 4.45 ± 1.74 mg per day. Patients with COPD and CHF of ischemic genesis of BB were prescribed significantly more often, and diuretics were significantly less likely than patients with COPD and CHF without myocardial infarction. Patients with COPD and CHF with ejection fraction of the left ventricle (LVEF) more than 40% were less likely to take BB than patients with COPD and CHF with reduced EF (less than 40%), and also less frequently, than patients with CHF without COPD with LVEF more than 40%.Conclusion: BB, as first-line drugs in the treatment of CHF, was prescribed on an outpatient basis only to half of patients with COPD and CHF, which does not comply with current guidelines for the management of patients with comorbid conditions. In the vast majority of cases, highly selective BB were prescribed. It should be noted low doses of BB, the absence of dose titration, which does not correspond to modern recommendations for the treatment of chronic heart failure.