OBJECTIVE To study effects of a selective beta1-adrenoblocker (B1AB) bisoprolol fumarate (conkor, Nikomed, Germany) on severity of pulmonary hypertension (PH), bronchial obstruction and bioelectric activity of the myocardium in patients with chronic obstructive pulmonary disease (COPD) associated with ischemic heart disease (IHD). METHODS Effects of an 8-week course of bisoprolol therapy on pulmonary hypertension, its efficacy and safety were studied in 30 IHD patients with COPD of stage III-IV on broncholytic therapy. The comparison group consisted of 45 IHD patients with COPD untreated with basic bisoprolol therapy. The following parameters were assessed: chest x-ray data, mean pulmonary artery pressure (MPAP) by echocardiography findings, frequency of anginal attacks by ECG monitoring, bronchial permeability by investigation of external respiration function, partial pressure and carbonic gas in blood, oxygen blood saturation (pO2, pCO2 and SaO2). RESULTS Bisoprolol has decreased MPAP from 23.8 +/- 0.8 mmHg to 21.9 +/- 1.0 mmHg, by 8%, p < 0.05; frequency of anginal attacks, heart rate from 82.2 +/- 1.4 to 73.2 +/- 1.5 b/min; number of episodes of ST segment depression from 2.35 +/- 0.43 to 0.95 +/- 0.22, p < 0.01; total duration of ST segment depression from 10.1 +/- 2.54 to 2.89 +/- 0.76 min, p < 0.01; number of supraventricular and ventricular extrasystoles for 24 hours from 194.5 +/- 74.4 to 96.2 +/- 27.4 and from 239.1 +/- 124.9 to 111.3 +/- 44.1, respectively. Parameters of a 6 min walk test improved from 326.7 to 442 m, p < 0.01. Bisoprolol had no negative effect on bronchial obstruction. CONCLUSIONS Bisoprolol is well tolerated, effective and safe in COPD patients with IHD.