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Fresh Air and β-Blockade

Paul E. Epstein, MD, Deputy Editor
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Requests for Single Reprints: Customer Service, American College of Physicians–American Society of Internal Medicine, 190 N. Independence Mall West, Philadelphia, PA 19106.

Ann Intern Med. 2002;137(9):766-767. doi:10.7326/0003-4819-137-9-200211050-00013
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In this issue, Salpeter and colleagues (1) present an important meta-analysis on the effects of cardioselective β-blockers in patients with reactive airway disease, a subject they have previously reviewed for the Cochrane Library (2). Their elegant analysis has helped put to rest a question that is both clinically important and controversial: Can cardioselective β-blockers be used safely in patients with recognized obstructive lung disease? The main focus in this meta-analysis is on patients with asthma. The question is clinically important because about 5% of the population of the United States is asthmatic and a substantial number of these patients also have a disease that can be treated effectively with β-blockers. It is controversial because many clinical guidelines still recommend that no type of β-blocker be used in patients with obstructive lung disease for fear that it might precipitate severe bronchospasm.

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