 Beta-blockers are pharmacologically different and there now needs to be an assessment of the clinical consequences of different beta-blockers in COPD. Despite being cardioselective, bisoprolol still shows significant beta-2-receptor blockade at usual treatment doses, which results in a significant worsening in Forced Expiratory Volume in 1second - FEV1 a major marker of lung function following chronic use. Celiprolol however is a unique beta-blocker which in addition to its beta-1-receptor blockade has partial beta-2-agonist activity and therefore it does not cause bronchoconstriction or interact with short and long acting beta-agonist inhalers which are the mainstay of COPD treatment. Thus celiprolol might confer an ideal profile for use in COPD i.e. good for heart and not detrimental to lungs, especially in more severe patients where even a small fall in FEV1 might have significant consequences on their breathing and exercise capacity. 