Bisoprolol fumarate tablets (Maintea) have significant therapeutic effects in the treatment of hypertension and angina pectoris, and their therapeutic efficacy is closely related to dosage adjustment. Discontinuation should follow a gradual principle to avoid rebound phenomenon, and individualized risk assessment is necessary for special populations.

1. Therapeutic effect

(1) Hypertension control: Taking 2.5-10mg orally once a day can reduce systolic blood pressure by 15-25mmHg and diastolic blood pressure by 10-15mmHg. The 24-hour stable blood pressure reduction rate is about 70%.

(2) Improvement of angina pectoris: reduce the frequency of attacks by more than 50%, increase exercise tolerance by 30%, and achieve better results when combined with nitrate drugs.

(3) Heart failure management: can reduce the mortality rate of NYHAI-II-IIII patients by 20-35%, requiring titration starting from a small dose (1.25mg/day).

2. Precautions for discontinuation of medication

(1) Indications for discontinuation of medication

When severe bradycardia, second degree or above atrioventricular block, or bronchospasm occurs, medication should be stopped immediately, but sudden arrest should be avoided in non emergency situations.

(2) Discontinuation plan

Reduce by 50% every 2-4 weeks. For those who consume 10mg/day, first reduce to 5mg and maintain for 2 weeks, then reduce to 2.5mg and continue for 1 week before stopping. The entire process takes 3-8 weeks.

(3) Monitoring requirements

During drug withdrawal, the heart rate and blood pressure were monitored weekly. Angina pectoris patients need to record the attack frequency, and diabetes patients need to strengthen blood glucose monitoring.

(4) Anti bounce processing

When blood pressure rebound or worsening angina occurs, the original dose should be restored and the interval between dose reductions should be extended to 4-6 weeks. If necessary, calcium antagonists should be used for transition.