Evidence map›Paper›PMID 28126029›Full record

ArticleBMC medicine2017

Respiratory effect of beta-blockers in people with asthma and cardiovascular disease: population-based nested case control study.

Daniel R Morales, Brian J Lipworth, Peter T Donnan, Cathy Jackson, Bruce Guthrie

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC medicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
38citing papers in PubMed, 1 pooled it
5.4field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

38 citing papers in PubMed, 1 synthesis or guideline pooled it, 94 citations in OpenAlex.

  1. Pooled it
  2. Review
  3. Review
  4. Review
  5. Article
  6. WAO - ARIA consensus on chronic cough: Executive summary.The World Allergy Organization journal · 2025
    Review
  7. Review
  8. Review
  9. Review
  10. Article
  11. Review
  12. Article
  13. Review
  14. Review
  15. Article
  16. Nonrespiratory Comorbidities in Asthma.The journal of allergy and clinical immunology. In practice · 2021
    Review
  17. Article
  18. Article
  19. The Use of β-Blockers in Heart Failure with Reduced Ejection Fraction.Journal of cardiovascular development and disease · 2021
    Review
  20. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 2 institutions in 1 country.

Daniel R MoralesQuality, Safety & Informatics Group, Division of Population Health Sciences, School of Medicine, University of Dundee, Mackenzie Building, Dundee, DD2 4BF, UK. d.r.z.morales@dundee.ac.uk.
Brian J LipworthScottish Centre for Respiratory Research, School of Medicine, University of Dundee, Dundee, UK.
Peter T DonnanDundee Epidemiology and Biostatistics Unit, Division of Population Health Sciences, School of Medicine, University of Dundee, Dundee, UK.
Cathy JacksonSchool of Medicine, University of Central Lancashire, Preston, UK.
Bruce GuthrieQuality, Safety & Informatics Group, Division of Population Health Sciences, School of Medicine, University of Dundee, Mackenzie Building, Dundee, DD2 4BF, UK.
University of Dundee · GBUniversity of Central Lancashire · GB

Funding

Chief Scientist Office CAF/11/07
6 · The paper itself

Abstract

backgroundCardiovascular disease (CVD) is a common comorbidity in people with asthma. However, safety concerns have caused heterogeneity in clinical guideline recommendations over the use of cardioselective beta-blockers in people with asthma and CVD, partly because risk in the general population has been poorly quantified. The aim of this study was to measure the risk of asthma exacerbations with beta-blockers prescribed to a general population with asthma and CVD.

methodsLinked data from the UK Clinical Practice Research Datalink was used to perform nested case-control studies among people with asthma and CVD matched on age, sex and calendar time. Adjusted incidence rate ratios (IRR) were calculated for the association between oral beta-blocker use and moderate asthma exacerbations (rescue oral steroids) or severe asthma exacerbations (hospitalisation or death) using conditional logistic regression.

resultsThe cohort consisted of 35,502 people identified with active asthma and CVD, of which 14.1% and 1.2% were prescribed cardioselective and non-selective beta-blockers, respectively, during follow-up. Cardioselective beta-blocker use was not associated with a significantly increased risk of moderate or severe asthma exacerbations. Consistent results were obtained following sensitivity analyses and a self-controlled case series approach. In contrast, non-selective beta-blockers were associated with a significantly increased risk of moderate asthma exacerbations when initiated at low to moderate doses (IRR 5.16, 95% CI 1.83-14.54, P = 0.002), and both moderate and severe exacerbations when prescribed chronically at high dose (IRR 2.68, 95% CI 1.08-6.64, P = 0.033 and IRR 12.11, 95% CI 1.02-144.11, P = 0.048, respectively).

conclusionsCardioselective beta-blockers prescribed to people with asthma and CVD were not associated with a significantly increased risk of moderate or severe asthma exacerbations and potentially could be used more widely when strongly indicated.

Indexed as

Adrenergic beta-AntagonistsAsthmaCardiovascular DiseasesCase-Control StudiesFemaleHumansMaleAdrenergic beta-AntagonistsAsthmaBeta-blockerCardiovascular diseaseDrug safetyPharmacovigilance

Identifiers

PMID28126029
PMCPMC5270217
OpenAlexW2582306762

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.