Bisoprolol is a cardioselective beta-blocker that primarily targets beta-1 adrenergic receptors in the heart, with minimal effect on the airways. This selectivity makes it the preferred choice over non-selective beta-blockers in patients who also have asthma or COPD, though caution is still required.
Bisoprolol is one of the most widely prescribed heart medications in the UK. It is used to treat heart failure with reduced ejection fraction (where it forms part of the foundational treatment regimen alongside ACE inhibitors and aldosterone antagonists), hypertension, angina, and rate control in atrial fibrillation. In cardiac arrest survivors, bisoprolol is frequently prescribed to reduce heart rate, lower arrhythmia risk, and protect heart muscle function.
Common side effects include fatigue, cold hands and feet, dizziness, and reduced exercise tolerance. The heart rate response to exercise is blunted, which means target heart rates during cardiac rehabilitation are typically set lower for people taking bisoprolol. Dose is adjusted by a cardiologist or GP based on resting heart rate, blood pressure, and symptoms. Bisoprolol should not be stopped suddenly without medical advice, as abrupt withdrawal can trigger rebound effects including arrhythmias.
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