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European Heart Journal 1985 6(10):845-850;
Copyright © 1985 by the European Society of Cardiology.
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© 1985 The European Society of Cardiology

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

R. S. KOHLI, N. S. KHURMI, M. M. KARDASH, L. O. HUGHES, A. LAHIRI and E. B. RAFTERY

Department of Cardiology, Northwick Park Hospital and Clinical Research Centre Watford Road, Harrow, Middlesex, U.K.

Received 13 February 1985; revised 6 June 1985; .

Address for reprints: Dr E. B. Raftery, Department of Cardiology, Northwick Park Hospital and Clinical Research Centre, Watford Road, Harrow, Middlesex, HA1 3UJ, U.K.

Abstract

Bisoprolol is a new cardioselective beta-blocker with a long half-life. The efficacy of once daily bisoprolol (10 mg) and atenolol (100 mg) was assessed in 20 patients with stable angina using a placebo controlled double-blind randomized crossover protocol. Efficacy was assessed by computer assisted treadmill exercise testing with monitoring of leads CMS and CC5, carried out 22–24 h after the last dose. The mean±SEM exercise time on placebo was 6.5±0.4 min increasing to 7.8±0.5 min 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 was also prolonged significantly with both drugs. The mean basal resting heart rate of 84±4 bpm decreased to 63±2 bpm on bisoprolol ( P<0.001 )and 64±3 bpm on atenolol (P<0.001), with a significant decrease in the peak exercise heart rate seen with both drugs (P<0.001). The peak rate-pressure product 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 One patient was withdrawn because he suffered a myocardial infarction.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 day for 6 weeks and an exercise test was performed at the end of this period. Bisoprolol retained its efficacy at the end of this period and was well tolerated. This data suggests that bisoprolol is an effective anti-anginal agent, comparable in efficacy and duration of action with atenolol, which is suitable for once-daily administration.

Key Words: Bisoprolol • atenolol • angina pectoris


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