Features of the choice of β-blocker in patients with chronic heart failure: the role of bisoprolol in overcoming sympathetic overdrive | Ukrainian Medical Journal

Zviahina O.V.

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Features of the choice of β-blocker in patients with chronic heart failure: the role of bisoprolol in overcoming sympathetic overdrive

Features of the choice of β-blocker in patients with chronic heart failure: the role of bisoprolol in overcoming sympathetic overdrive

February 27, 2026

101

Cardiology, Rheumatology

Therapy, General practice

Zviahina O.V.

УДК: 616.1

DOI: 10.32471/umj.1680-3051.273676

Keywords :

bisoprolol,

chronic heart failure,

chronic obstructive pulmonary disease,

Concor®,

diabetes mellitus,

sympathetic overdrive,

β-blockers

Specialities :

Cardiology, Rheumatology

Therapy, General practice

Resume

Chronic heart failure is characterized by chronic activation of the sympathetic nervous system (sympathetic overdrive), which contributes to myocardial remodeling, progression of systolic and diastolic dysfunction, increased risk of ventricular arrhythmias and sudden cardiac death. β-Blockers are the only class of drugs capable of interrupting the vicious circle of sympathetic overdrive, reducing the toxic effect of catecholamines on the myocardium, slowing down left ventricular remodeling and reducing the frequency of hospitalizations, which is confirmed by international clinical recommendations and numerous randomized studies. Bisoprolol (Concor^®) is distinguished by its high β₁-selectivity across the therapeutic dose range, prognosis-modifying effect even at low doses, minimal risk of bronchoconstriction and metabolic disorders, predictable pharmacokinetics and convenient titration. This makes it the reference β-blocker for the treatment of chronic heart failure, including high-risk patients and comorbid conditions such as diabetes mellitus and chronic obstructive pulmonary disease, providing safe and effective suppression of sympathetic overdrive and improved survival.

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