Efficacy and safety of the selective β-blocker bisoprolol in patients with cardiovascular and broncho-obstructive diseases
Objective. To investigate the safety and efficacy of selective β-blocker bisoprolol in patients with cardiovascular and broncho-obstructive disease. Materials and methods. The study included 31 patients with cardiovascular and broncho-obstructive (chronic obstructive pulmonary disease (COPD) and asthma) diseases and 35 patients suffering from cardiovascular diseases (hypertension, ischemic heart disease, cardiac arrhythmias). Safety Based β-Blockers (β-B) was assessed by a 4-hour spirometric tests with β-B, the results of computer spirometry, using a questionnaire and COPD Assessment Test (CAT) scale Medical Research Council Scale (MRC). Efficacy of this drug was determined using ambulatory blood pressure monitoring, Electrocardiographic Holter monitoring, as well as the dynamics of clinical symptoms and exercise tolerance (test with a 6-minute walk). Results. According to the 4-hour spirometric tests with β-B only two patients with cardiovascular disease (CVD) and broncho-obstructive disease a marked decline in forced expiratory volume in one second (FEV1). During the 12-week study in patients with cardiorespiratory pathology there was no reduction of bronchial patency according to the results of computer spirometry (baseline forced expiratory volume in the 1st s (FEV1) - 76± 17% at the end of the observation period FEV1 - 79 ± 19 %). In the combined antihypertensive therapy with bisoprolol significantly reduced both systolic and diastolic blood pressure showed a trend toward an increase in distance traveled from 460 ± 83 to 485 ± 72,9 meters. In our study shows rhythm, slows and antiarrhythmic effects of bisoprolol in patients with CVD and the broncho-obstructive disease. According to the questionnaire CAT and MRC scale was a significant reduction in the severity of symptoms on a 12 week treatment with bisoprolol (on a scale of CAT from 11,5 ± 8,8 to 7,7 ± 6,6 points, on a scale MRC c 1,7 ± 0,8 to 0,9 ± 0,6 points (p = 0,01)). Conclusions. Long-term use of bisoprolol in patients with CVD and broncho-obstructive disease proved safe, effective and justified when indicated. Nevertheless, the need to control the parameters of respiratory function and identification of patients at high risk of bronchial obstruction, even against the background of a single dose of highly selective β-B.