New Trial Shows Beta-Blocker Bisoprolol Safe for People with COPD and Heart Failure

A major international study has found that the beta-blocker bisoprolol — commonly used to treat high blood pressure (hypertension), angina (coronary heart disease) and heart failure — is safe for people living with chronic obstructive pulmonary disease (COPD), overturning previous concerns about its use in this population.

COPD is one of New Zealand's  leading causes of hospital admissions. People with COPD often die from cardiovascular disease almost as frequently as from their lung disease, making effective heart treatment critical. However, this group has historically been excluded from cardiovascular trials, due to concerns about potential adverse effects, leaving clinicians uncertain about the safety of common therapies.

Beta-blockers were long thought to be contraindicated for people with COPD, despite evidence from large databases suggesting that this class of medication could reduce mortality and hospitalisations.

The new two-year, multicentre randomised controlled trial, published in Lancet Respiratory Medicine, shows that bisoprolol, a cardio-selective beta-blocker, is safe for people with COPD. However, the study did not demonstrate additional benefits for the broad COPD population included in the study. These findings indicate that further research is now required to determine whether  bisoprolol is beneficial for individual COPD patients with specific clinical characteristics.

Professor Richard Beasley, MRINZ Director, says, “The PACE trial provides important evidence to guide safe cardiovascular treatment for people living with COPD. MRINZ was pleased to contribute to this work alongside international collaborators from Australia, NZ, India and Sri Lanka.”

The trial offers much-needed reassurance for clinicians treating people with both COPD and heart disease, addressing a long-standing area of uncertainty and helping inform evidence-based care in New Zealand.

View details for the full study HERE.