Table 2 Inclusion and exclusion criteria

Inclusion criteria

 • A diagnosis of COPD confirmed by spirometry showing a post-bronchodilator value of FEV₁/FVC < 70 and a history of tobacco smoking or occupational/environmental exposure to smoke, gas, or dust

 • ≥40 years of age

 • Sinus rhythm ≥50/min and < 120/min at inclusion

 • Written informed consent

Exclusion criteria

 • Known hypersensitivity to metoprolol or related derivatives

 • AV block II or III unless treated with a pacemaker

 • Sinus bradycardia (resting heart rate < 50/min)

 • Sick sinus syndrome unless treated with a pacemaker

 • Atrial fibrillation/flutter

 • Clinical signs or previous diagnosis of heart failure, angina pectoris, myocardial infarction, cerebrovascular disease, or critical peripheral ischemia

 • Systolic blood pressure < 90 mmHg

 • Tachyarrhythmia other than sinus tachycardia

 • Sinus tachycardia > 120/min

 • Severe bronchial asthma

 • Current beta-blocker treatment

 • Inability to provide informed consent

 • Age < 40 years

 • Acute on-going exacerbation of COPD

 • Previous randomization in the trial

 • Pregnancy (confirmed by pregnancy test when appropriate)