β-Blockers are highly efficacious in the treatment of congestive heart failure and ischemic coronary syndromes and can reduce the total mortality of patients with these disorders by 30% to 40%.1 However, their use is frequently withheld inpatients who have coexisting chronic obstructive pulmonary disease (COPD) because clinicians fear that β-blockers will provoke bronchospasm and induce respiratory failure in these patients. Not surprisingly, large epidemiological studies have shown that fewer than one-third of patients with COPD receive β-blockers after an acute coronary event2 despite compelling data that they prolong life and improve health outcomes in such patients.1