Should calcium channel blockers be used in patients with chronic obstructive lung disease or a history of asthma?
Beta blockers without intrinsic sympathomimetic activity should be used, especially beta-1 blockers such as sustained-release metoprolol succinate, bisoprolol, or carvedilol, a beta-1 and alpha-1 blocker. This is because of their mortality benefit in patients with HF and systolic dysfunction.246,247 In patients with chronic obstructive lung disease or a history of asthma, beta blockers are not contraindicated in the absence of active bronchospasm. Beta-1 selective beta blockers are preferred and should be initiated at a low dosage. See Online Data Supplement 11 for additional information on beta blockers, including risk factors for shock.