Efficacy of once daily bisoprolol in stable angina pectoris: an objective comparison with atenolol and long term follow-up

Bisoprolol is a new cardioselective beta-blocker with a longhalf-life. The efficacy of once daily bisoprolol (10 mg) andatenolol (100 mg) was assessed in 20 patients with stable anginausing a placebo controlled double-blind randomized crossoverprotocol. Efficacy was assessed by computer assisted treadmillexercise testing with monitoring of leads CMS and CC5, carriedout 22–24 h after the last dose. The mean±SEM exercisetime on placebo was 6.5±0.4 min increasing to 7.8±0.5min on bisoprolol (P<0.001) and 8.6±0.6 mins on atenolol(P<0.001). The time to 1 mm ST depession in CM5 and CC5 wasalso prolonged significantly with both drugs. The mean basalresting heart rate of 84±4 bpm decreased to 63±2bpm on bisoprolol ( P<0.001 )and 64±3 bpm on atenolol(P<0.001), with a significant decrease in the peak exerciseheart rate seen with both drugs (P<0.001). The peak rate-pressureproduct was 175±8 after placebo, 146±7 (P<0.001)with bisoprolol and 149±5 (P<0.001) after atenolol.One patient was withdrawn because he suffered a myocardial infarction.Eighteen patients were prescribed bisoprolol 10 mg once a dayfor 6 weeks and an exercise test was performed at the end ofthis period. Bisoprolol retained its efficacy at the end ofthis period and was well tolerated. This data suggests thatbisoprolol is an effective anti-anginal agent, comparable inefficacy and duration of action with atenolol, which is suitablefor once-daily administration.