How can low dose selective beta receptor blocker affect AECOPD patients with core pulmonale

Chronic obstructive pulmonary disease (COPD) is the fourth leading cause of death and is estimated to rise to be the third most common cause of death worldwide by 2020. Many patients with COPD have concomitant conditions, mostly coronary artery disease (CAD) that requires the use of betablockers (BBs). However, despite the clear evidence of BBs effectiveness, there is a general reluctance to use them in patients with COPD due to a perceived contraindication and fear of inducing adverse reactions and bronchospasm