ORIGINAL RESEARCH

Initial administration of β2-agonists reduces the risk of bronchospasm caused by β1-blockers in comorbid cardiorespiratory pathology

Smolyakova EV1,2, Sinitsyn EA2, Zykov KA1,2
About authors

1 Evdokimov Moscow State Medical and Biological University of the Ministry of Health of Russia, Moscow, Russia

2 Pulmonology Research Institute, Federal Medical Biological Agency, Moscow, Russia

Correspondence should be addressed: Ekaterina V. Smolyakova
Orekhovy bulvar, 28, 115682, Moscow, Russia; ur.liam@kavokayloms

About paper

Author contribution: Smolyakova EV — recruitment of patients, processing of the results, article authoring; Sinitsyn EA — discussion of the results; Zykov KA — patient treatment management, discussion of the study results, article authoring.

Compliance with ethical standards: the study was approved by the Ethics Committee of the National Medical Research Center for Cardiology named after academician Yevgeniy Chazov of the Ministry of Health of the Russian Federation (Minutes № 220 of October 31, 2016)

Received: 2023-07-21 Accepted: 2023-09-04 Published online: 2023-09-28
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In the treatment of patients with cardiorespiratory pathology, it is often necessary to simultaneously administer drugs that affect β-adrenergic receptors: β1-adrenoblockers and β2-agonists. β1-blockers can trigger a bronchospasm in patients with bronchoobstructive diseases, therefore, practitioners often decide not to prescribe them. This work aimed to evaluate functional parameters of patients with cardiovascular and bronchoobstructive diseases in the context of different sequences of administration of selective β1-blockers (bisoprolol) and long-acting β2-agonists (formoterol). This prospective, single-center 2-week pilot study involved 30 individuals suffering the aforementioned diseases. Using the envelopes method, we divided the patients into two groups of 15 people each. First group started therapy with a long-acting β2-agonist, second group — with a selective β1-adrenoblocker. While taking the β1-adrenoblocker, patients underwent a four-hour spirometric test enabling assessment of the external respiration function parameters. The tests and assessments have shown that the value of FEV1 went down in 33.3% of those who started therapy with a selective β1-adrenoblocker (bisoprolol 2.5 mg), and in the group that first took a long-acting β2-agonist for a week and then added bisoprolol 2.5 mg to the regimen the said value dropped in 7% of patients only. Thus, preceding long-acting β2-agonists, formoterol in particular, reduced the risk of bronchospastic incidents triggered by selective β1-adrenoblocker (bisoprolol) in patients with cardiorespiratory pathology.

Keywords: cardiovascular diseases, bronchoobstructive diseases, cardiorespiratory pathology, β1-adrenoblockers, β2-agonists

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