CLINICAL PRACTICE OF BETA-BLOCKERS USAGE IN PATIENTS WITH CARDIOVASCULAR AND CHRONIC RESPIRATORY DISEASES. DATA OF OUTPATIENT REGISTRIES PROFILE AND RECVASA

• Main Authors: S. Yu. Martsevich, N. A. Zakharova, N. P. Kutishenko, A. V. Zagrebelnyy, Yu. V. Lukina, M. M. Loukianov, A. N. Vorobyev, A. N. Kozminsky
• Format: Article
• Language: English
• Published: Stolichnaya Izdatelskaya Kompaniya 2017-09-01
• Series: Racionalʹnaâ Farmakoterapiâ v Kardiologii
• Subjects: beta-adrenoblockers; contraindications; chronic obstructive pulmonary disease; bronchial asthma; registries
• Online Access: https://www.rpcardio.com/jour/article/view/1506
• ISSN: 1819-6446; 2225-3653

Aim. To assess the practice of using beta-adrenoblockers (β-AB) in patients with cardiovascular diseases (CVD) in the presence of limitations (chronic obstructive pulmonary disease – COPD) and contraindications (bronchial asthma – BA) in two outpatient registries PROFILE and RECVASA.Material and methods. The data of the PROFILE registry organized in the specialized cardiological unit of the medical research center in Moscow from 2011 to 2015 (n=1531) were analyzed as well as data of the RECVASA registry included patients who applied to 3 city outpatient clinics in Ryazan from 2012 to 2013 (n=3690).Results. In the RECVASA registry 279 patients had COPD (mean age 73 years; 59.4% males); in the PROFILE registry 286 patients had COPD (mean age 66 years; 50.2% males). In the presence of COPD in the PROFILE registry, β-AB were prescribed more often (51.1%) than in the RECVASA registry (31.5%, p<0.01), primarily to patients with high cardiovascular risk [after myocardial infarction (MI) and in patients with chronic heart failure (CHF)]. In the PROFILE registry 28 patients had BA (mean age 67 years; 46.4% males); in the RECVASA registry – 188 patients (mean age 64 years; 16.5% males). In patients with BA the frequency of β-AB prescription decreased in both registries: 28.6% in the PROFILE registry and 19.1% in the RECVASA registry (p<0.01). In the PROFILE registry the presence of COPD did not influence β-AB administration is patients with ischemic heart disease and MI history; in the RECVASA registry in the presence of COPD the probability of β-AB administration decreased in patients with ischemic heart disease, MI and CHF. In the presence of BA the probability of β-AB administration decreased in both registries in all patients except hypertensive ones.Conclusion. Physicians of a specialized institution are more active than physicians of outpatient clinics in prescribing β-AB in COPD when direct indications to β-AB are present (previous MI, CHF) except uncomplicated hypertension. In patients with CVD and BA, doctors in both registries try not to prescribe β-AB. However, in uncomplicated hypertension, BA was often not taken into account, while prescribing β-AB.