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The use of β-blockers in patients with heart failure and comorbidities: Doubts, certainties and unsolved issues
β-blockers represent a mainstay in the pharmacological approach to patients affected by heart failure with reduced ejection fraction (HFrEF). However, underuse of this class of drugs is still reported, especially in the presence of cardiovascular and non-cardiovascular comorbidities, even if they are not contraindications for prescription of a β-blocker. The prognostic benefit of β-blockers is relevant in the presence of comorbidities, and achievement of the maximum tolerated dose is an important goal to increase their favorable prognostic role.Understanding the impact of chronic obstructive pulmonary disease exacerbations on patient health and quality of life
Chronic obstructive pulmonary disease (COPD) was the third leading cause of mortality in 2016 and was responsible for an estimated 3 million deaths worldwide that year, representing a vast global problem [1]. COPD exacerbations are responsible for the majority of the substantial burden that COPD places on healthcare systems [2,3]. In the USA, the annual cost of COPD management has been shown to increase proportionally with the number of COPD exacerbations, with COPD-related costs, including pharmacy claims for COPD treatments, more than six times higher in patients experiencing frequent (≥2/year) exacerbations ($4361) compared with those who had none ($644) [4].
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