This study examined data from 19 studies of single dose treatment and 10 studies of continued treatment with cardioselective β blockers (atenolol, metoprolol, bisoprolol, practolol, celiprolol, acebutolol and xamoterol) in patients with reactive airway disease (asthma or COPD with reversible obstruction). After single dose administration there was a 7.46% decrease in FEV₁ and a 4.63% increase in FEV₁ response to β agonist compared with placebo with no increase in symptoms. In trials lasting 3 days to 4 weeks no significant changes were seen in FEV₁, symptoms, or inhaler use, but β agonist response was increased by 8.74%. No significant treatment effect on FEV₁ was found in patients with COPD.

Cardioselective β blockers do not cause clinically significant adverse respiratory effects in patients with mild to moderate reactive airway disease, including COPD. In view of the demonstrated benefits in cardiovascular disease, such treatment should not be withheld in this group of patients.