Comparative effects of celiprolol, propranolol, oxprenolol, and atenolol on respiratory function in hypertensive patients with chronic obstructive lung disease

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Abstract
The aim of the study was to compare the pulmonary effects of four beta-blockers with different ancillary properties: propranolol (non-beta1 selective without ISA), oxprenolol (non-beta1 selective with ISA), atenolol (beta1 selective), and celipropol (beta1 selective with mild beta2-agonist and alpha2-antagonist activity) in hypertensive patients with chronic obstructive lung disease. Ten asthmatic patients, all males, aged 50–66 years were studied. Entry criteria were a) DBP≧95 mmHg and ≦115 mmHg; b) FEV11 increase of at least 20% after salbutamol inhalation (200 μg). After a 2-week washout period on placebo, each patient received propranolol (80 mg/day), oxprenolol (80 mg/day), atenolol (100 mg/day), and celiprolol (200 mg/day) for 1 week, according to a randomized, cross-over design. At the end of the washout and of each treatment period, airway function, assessed by FEV1, FVC, and FEV1%, was evaluated by spirometry both in the basal condition and after salbutamol inhalation. Unlike propranolol and oxprenolol, which significantly reduced FEV1 and inhibited the bronchdilator response to inhaled salbutamol, atenolol and celiprolol did not significantly affect respiratory function and did not antagonize salbutamol effects. Celiprolol more closely approached placebo in its respiratory effects than did atenolol, although the differences were not statistically significant.