Effect of bisoprolol on exercise tolerance in patients with coronary heart disease: placebo-controlled double-blind crossover study

Twelve patients with stable angina pectoris due to coronary heart disease received single oral doses of 5, 10, and 20 mg bisoprolol in a placebo-controlled double-blind crossover study. A significant, dose-related increase in exercise tolerance in symptom-limited bicycle exercise tests performed 2.5 h after administration (p less than 0.05) was demonstrated. The dose-effect relationship was especially marked in reduction of heart rate, rate-pressure product, and ischemic ST-segment depression at the highest comparable workload (p less than 0.01). Compared with placebo, mean improvements in work performance (determined by the maximal workload attained, i.e., W X minutes) increased to 105% with 5 mg, to 122% with 10 mg, and to 131% with 20 mg bisoprolol. The lower incidence rate of exercise-induced symptoms of angina pectoris at an identical workload was marked at the 10- and 20-mg dose.