Background Due to common risk factors, there is considerable number of COPD patients who has concomitant heart failure. There is always reluctance in prescribing beta blockers in patients with COPD, though recent literature has supported the use of cardio-selective beta blockers among these patients. We conducted this study to determine the effect of cardio-selective beta blockers on dyspnea grade and exacerbation rate among COPD patients with concomitant heart failure.

Methods This was a prospective cohort study among COPD patients with concomitant heart failure, conducted in a clinic during the last one year. Patients were recruited into 2 groups those who were prescribed cardio- selective beta blockers (group 1) and those managed without beta blockers (group 2). Patients were followed for one year. Outcomes measured were the reduction in MRC dyspnea grade and reduction in number of exacerbations in this year as compare to last year. Those patients having renal disease, liver disease, cancer, any Pneumonia leading to hospitalisation, stroke, etc. were excluded from the study.

Results Total of 95 patients (45 in group 1 and 50 in group 2), mean age 61.3±11 years, BMI 27.5±6.8, mean COPD exacerbation rate of 2.45±0.8 were included in the study according to inclusion criteria. There was statistically significant difference in the two groups regarding their smoking history and BMI, though no difference in the gender distribution and mean COPD exacerbation rate in the last year. At the end of one year follow up, we found statistically significant difference in reduction in COPD exacerbation rate and reduction in dyspnea grade with p<0.05.

Conclusion Cardio- selective beta blockers when prescribed among sub group of COPD patients who had concomitant heart failure may benefit in terms of reduction in dyspnea grade and reduction in COPD exacerbation rate.