Bisoprolol Resting Heart Rate - British Heart Fou...

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Bisoprolol Resting Heart Rate


Hi, I've been put on 2.5mg Bisoprolol twice daily for some tachycardia that came up on an 48 hr ECG just over a week ago, as well as several other BP meds to lower my BP which was very high, been on those for 7 weeks.

I understand that the whole point of the Bisoprolol is to lower my Heart rate at it has been hovering in the 41-45 region on most days since I started it, however my Apple Watch just warned me it was too low and I checked on my BP monitor and it was 38. Does this justify a call to NHS Direct, Saturday evening so no GP? I am a a tad worried although I feel fine, BP is normal 125/77? Is this normal on beta blockers? Am due to take another 2.5mg tonight.

35 Replies

38 is low, when did you take it and have you taken it with finger on your pulse as that really is the best way to take it.

Thecyclist in reply to Lezzers

Took it at 11am this morning so a fair while ago, no just taken with a BP monitor which is usually accurate.

Lezzers in reply to Thecyclist

Try taking it again but this time do the finger on pulse. My husbands nurse always did it that way even though she has a BP monitor reading

Thecyclist in reply to Lezzers

Seems to have gone back to normal now, taken it a couple of times so maybe just a one off, I was quite chilled at home!

Lezzers in reply to Thecyclist

Possibly a one off, the main thing is you don't feel dizzy or faint. Perhaps keep your eye on it but don't obsess.

Thecyclist in reply to Lezzers

Thanks both, yes I'm a worrier and this is all new to me unfortunately, my wife said not to worry, but you know how it is. This forum has been great though! I'll keep an eye on it until later and if it does drop again I'll call the experts! Thanks.

Hi there don’t worry just phone 111 and eventually you will speak to the right doc to advise you he may say to stop meds for now but you will be sorted tonight. Take care xxx

Hi there. I see from the thread that you’re now OK. Brilliant. Just to say that Apple watches are known for being really unreliable. The main thing to watch out for is if you’re dizzy or falling over and not recovering.


Hiya, I’m also on 2.5mg Bisoprolol for tachycardia and my heart rate dips in and out of the 40s every day and I feel absolutely fine it has on occasion gone into higher thirties but again felt fine I think it is a common issue when on beta blockers. I haven’t told my gp yet as I feel fine within myself I think il casually mention it when I next see her but I would personally say something even if it is to your gp when you next see them to just so they are aware! A lot of people on this forum have the same issue so it might be worth having a read like I did! However if you are worried then don’t hesitate to contact someone like 111 even for reassurance that’s what they are there for!

Thecyclist in reply to Hidden

Thanks for the reassurance, sounds like there are quite a few of us who have this as well!

nobby1st in reply to Thecyclist

i am on 6.5

Hi, I also do a lot of cycling (or did until recently). I’m a 63 year old male. I used to ride about 100 miles a week. I noticed on some rides that my hr would jump from say 100 to 160 (not a normal rise as I exercised but a sudden jump). I have SVT. I lived with it for a while but it got more frequent and now it would be about 160 most of the time without being controlled by me now taking 1.25 mg of Bisoprolol. My resting hr was about 45 before starting the meds and I was a bit worried because the notes say don’t take it if you have a resting hr below 60. I spoke to my GP and my cardiology nurse about this and they both assured me I will be ok. My hr now drops to about 35 on resting. I can measure it on a fitbit (not always accurate) and a garmin chest strap and cycle computer (which is accurate).

I’ve been told that as long as I feel ok, no fainting or anything, then I will be ok.

I’m waiting for an ablation, after which I’m hoping that I can stop the meds and my hr can go back up to 45 on resting.

Basically consult your GP and cardiologist and if you feel ok then you should be.

Thecyclist in reply to Fazerboy

Wow, sounds like exactly what happened to me, although I had really bad palpitations and it only happened on hills, like you was doing a fair few miles, 70-100 km a week and usually lots of climbing (I live in hilly Wales!), my HR was doing similar, but I also had an episode of Tachycardia at rest, went 169 for a few seconds and straight back down again, didn't feel it but was caught on an ECG.

My Echo has come back all clear , slight dilation of left side so not sure what the tachycardia is from. My resting HR was 55 before the meds and when bike fit, so it was quite low anyhow.

I think I just panicked last night as I have never seen it drop below 40 but as you did I felt fine, no dizziness. Clearly it's OK, so I will just keep an eye on it.

Good luck with the ablation!

I noticed my high hr episodes because I got really tired at times riding up really gentle inclines. I decided to open my Xmas present early, a garmin hr monitor. This showed up my high hr episodes (it would suddenly shoot up then drop just as quick, sometimes after a few minutes but at worse after about 2 hours). For info, I found that I could get mine to reset and drop back to normal by lying on my back for about a minute. Not always easy to find somewhere suitable though LOL.

Also, adrenalin sent my hr racing, ie if after a surprise like a near miss when cycling or something.

After seeing my cardiologist I then had a Linq recorder fitted. This helped them diagnose the SVT (AVNRT to give it its full name). As I said, I'm waiting for an ablation now.

Thecyclist in reply to Fazerboy

My Garmin was a life saver it was that which caused me to stop, I would have ignored the palpitations otherwise, they are are wise investment!

Fazerboy in reply to Thecyclist

Agreed. I have worn my hr monitor strap in the day when not even cycling and carried the garmin in the past.

I’m so used to my symptoms now that I don’t need the confirmation. Now I’m on Bisoprolol I hardly ever get an episode.

Hi you said u took 1 Bisoprolol in morning but was due to take another in the evening.

In my experience Bisoprolol is one a day which is why most are in calendar packs marked with days.

If on 5mg a day usually one dose an 5mg is fairly high dose.

I'm on 3,75mg daily HR lowest 44.

Thecyclist in reply to BigT2013

My consultant prescribed this dose, as my episode was Broad Complex Tachycardia (not a nice tachycardia apparently) which she was quite worried about, my episode happened at 8.30 am so I am guessing she wants to make sure my HR is down all the time hence the need of one in the evening to carry me though the night. I'm also a big chap which may explain a higher dose.

I would speak to your GP. My blood pressure and heart rate used to go very low on Bisoprolol when on that dose. They reduced it then slowly increased it again so I didn’t get the same issue.


I take a 7.5mg Bisoprolol down from 10 mg and because I have to take a weeks readings to my Heart Failure Cardiologist/Nurse tomorrow I have a weeks results to hand.

102/44 105/64 105/58 99/64 108/66 100/43 127/65

HR 56 64 57 57 56 50 54 So heart rate pretty steady, BP a bit up and down !!! and that's with Entresto at 24/26 mg twice a day, Eplerenone 25mg once a day. Hope that gives you some idea of someone else's Heart Rate on Bisoprolol. I take my readings in the morning around 7 am.


No harm in ringing NHS Directo although in my experience, their stock answer is to send you to A&E which in my area is anything between a 6-8hr wait. But I see it has settled which is great. I wish my HR was around the 50 mark, more like 80+. Sometimes I think we can all get locked into over-worrying perhaps? Good wishes and good luck.

I'm 12 weeks post ablation for re-entrant SVT & was taking 1x 1.25 mg Bisoprolol my resting heart rate dropped as low as 32bpm on occasions. I was taken OFF bisoprolol for 10 weeks after ablation then put back on 1x 2.5mg now reduced to 1.25 again. Generally I feel ok resting around 45bpm but with a lot of ectopics & some sudden spikes in heart rate up to 160 bpm just strolling in town, but NO symptoms of svt (tight & heavy chest). I do get light headed & dizziness if sat in a low chair, so I now avoid them where possible. I've not been allowed to drive since April 2019 so I'm getting even more impatient Grr. I just wish my heart would settle down & behave more rhythmically but have been told improvements can take ages. Follow up appointment with EP at Stoke in 2 weeks time everything will be crossed. Good luck with your own issues YOU ARE NOT ALONE!!

Like you, I have had low rhr when on bisoprolol and have had my daily dosage reduced to minimum level of 1.25mgs per day. Originally I was on 5mgs pd, then after my 2nd heart op on 2,5mgs pd, feeling dizzy and listless so dose was halved again. My rhr can still be 47-49 bpm according to my Garmin device but cardiologist says so long as I'm not feeling symptomatic a little is better than none at all.

When I first complained of my low rhr, the GP thought my device was faulty but then her first comment on checking with her equipment was "Oh! It is low....."

I would suggest you make contact with either your GP or dial 111. Likelihood is that they will suggest you reduce the dose. If your pills are 2.5mgs in size you can get a pill splitter from pharmacy or Amazon quite easily.

I've been on 1.25mgs for a good 18 months now. I don't like the drug but know the cardiologist is right that a little is better than none.

I’m having the same trouble this weekend! I have Left Ventricular Systolic Dysfunction. Was started on Lisinopril along with my usual Ditilizem but have been taken off Ditilizem as its not helpful with my condition. Started Bisoprolol 2.5mg in Friday and i’ve spent the weekend terrified (i have anxiety and panic attacks!) My pulse is 45 bpm and im constantly checking it on a little finger monitor..i’m petrified! But keep thinking the cardiologist knows best! Just trying to stay calm for tonight and i’ll ring docs tomorrow!

Thanks so much for all the great comments all, so good to know I'm not the only one having these issues. I've been fine today, so far, pulse has been around 41-45 all day. I'll give the GP a call tomorrow and see what they say. This is all so new to me, I've not had to take any medication in my life other than the usual pain killers, so the whole medication/side effect thing is taking some getting used to! Reading these comments makes me feel less worried that's for sure and that these are all "normal" things.

Lezzers in reply to Thecyclist

Let us know how you get on with the GP or if you're worried call 111 for advice. My husband couldnt tolerate 2.5 as his BP dipped too low, GP reduced it to 1.25 and he's fine on that. HR was never really an issue though.


I’m on 7.5 daily. I was told to seek medical advice if it fell below 50 for more than half an hour. I wear a Fitbit at all times.

38 is ridiculously low! Stop taking them and go see your doctor or some other doctor if he was the one who gave you the bisoprolol . Why didn’t he take your resting heart rate measurement first and if he did then surely he must know that average resting heart rates are 65 -75 bpm .

Lezzers in reply to PeterK2

You should never just stop taking beta blockers you need to be weaned off them gradually otherwise you could cause all sorts of problems.

Thecyclist in reply to Lezzers

Totally agree I wouldn't change my meds unless explicitly told to by a doctor.

Prada47 in reply to PeterK2

Please don't suggest people stop taking any medication prescribed by a medical professional it could be Extremely Dangerous. I think it is a condition of the forum that you don't offer medical advice so please refrain. You have no idea of any other medication that the poster is taking, it may not be the Bisoprolol that is causing the Low heart Rate. My Cardiologist stopped Furosemide and Isosorbide to bring my Blood Pressure Up but he left Bisoprolol at 7.5mg !!! We are all different.

Yes it was low and thankfully not gone that low again today so maybe a one off yesterday. The doctor will have known my "normal" resting HR as the prescription came off the back of a 48 hr ECG. But you might have read I had an episode of Broad Complex Tachycardia, my HR went to 169 for a few seconds and such tachycardia can be very dangerous (although aren't they all!) so the Bisoprolol I am guessing is to keep my HR as low as possible. 38 is getting on the margin the other way though, so it may just require a dose change. In any case I'll be speaking to them tomorrow and seeking advice.

Lezzers in reply to Thecyclist

My husband is on bisoprolol because he'd had 44 vt's, thankfully they self terminated but it's worrying that these things are going on & you have no idea!! His were picked up on his ICD check up.

This time last year I was on Bisoporol 5mg then told to split the dose into am/pm then down to 1.25mg - reason being on 5mg hr = 49-45 which my GP said was too low. I didn't feel dizzy etc but weak, heavy chest feeling & lot ectopics & v tired. After splitting dose I could feel HR going up by early evening and was glad to know I would be able to take 2nd dose soon. But, all in all I just couldn't manage to get dose right & felt generally unwell. Cardiologist prescribed Diltiazam but again I went from low to high dose & feel so much better. The dose can be increased if needed. They are slow release & so no sudden dip in HR.

Any form of heart problems - AF SVT etc are not easy to cope with especially in the begining when it is as you say something new. It was quite scary & if I'm honest like others who have posted on the forum it is as if you are always on the alert waiting for it to start up. Gradually, you learn to cope & I have found this forum reassuring along with some excellent tips. You are not alone, do keep us posted when you can

Hi, You've been given great advice by everyone but I do suggest you read the leaflet that comes with the medication as it can reassure you! I tend not to read them until I think somethings amiss, so as not to influence myself, then have a look. Sounds like you're doing well though.

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