Bisoprolol is a highly selective beta-1 adrenergic receptor blocking a
gent that provides 24-hour blood pressure control with once daily dosi
ng. Although the drug was recently approved by the FDA only for the tr
eatment of hypertension, it appears to be safe and effective for the t
reatment of both hypertension and angina according to published studie
s. Adverse effects associated with bisoprolol's use are primarily rela
ted to its beta blocking and electrophysiologic properties and include
fatigue, bradycardia, hypotension, headache, cold extremities, and di
zziness. The drug has minimal effects on lipids, although elevations i
n triglycerides have been reported. Bisoprolol does not appear to adve
rsely affect patients' quality of life, unlike noncardioselective beta
blockers. If competitively priced, bisoprolol may provide an excellen
t alternative to beta-adrenergic blocking agents already on the formul
ary.