Head‐to‐head comparison of the heart rate variability between the bisoprolol transdermal patch and bisoprolol fumarate tablet

Summary Aim The bisoprolol transdermal patch is a newly developed β‐blocker designed to deliver its pharmaceutical ingredient through the skin surface. We aimed to compare the bisoprolol transdermal patch and bisoprolol fumarate tablet using the heart rate variability (HRV). Method Eligible hypertensive patients received a 2‐week administration with a 2.5 mg bisoprolol fumarate tablet, followed by 24‐hour Holter monitoring. The tablet was then switched to a 4 mg bisoprolol transdermal patch, and after 2 weeks of its administration, the Holter monitoring was repeated. Both drugs were given once daily. Endpoint was any alteration in the HRV caused by a change in the administration route for bisoprolol. Results There was no difference in the 24‐hour time‐domain and frequency‐domain HRV measurements before and after the drug switching among patients recruited (N = 30). However, the switching significantly altered the time‐course curves of the hourly HRV measurements, including the mean normal‐to‐normal (NN) interval (P = .004), standard deviation of the NN index (P