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Tachycardia (POTS) and Bisoprolol: Is it safe? How does it work? Research studies? Evidence?

Postural Orthostatic Tachycardia Syndrome, more commonly known as POTS, is a heart condition wherein people have an abnormal heart rate when they stand up, which can cause a lot of unpleasant symptoms like lightheadedness, dizziness, and even fainting. Bisoprolol, part of the beta-blockers family of medicine, is a treatment used to address the symptoms of POTS. 

POTS is a type of dysautonomia, a nervous system disorder. As per most medical guidelines, it is characterized by an excessive heart rate increase (by more than 30BPM) within a 10 minute timeframe of standing. It can also be observed by a heart rate higher than 120 BPM where blood pressure does not change significantly. 

Bisoprolol is a selective beta-1-adrenergic receptor blocker. This means that it blocks the receptors responsible for an increase in heart rate by upping heart contractions. Thus, by its blocking action, heart rate stability and consistency increases, and POTS symptoms are relieved. In essence, it works by blocking adrenaline and norepinephrine hormone receptors; thus reducing palpitations significantly. 

The medication is available by prescription, and should be used only under guidance of a healthcare provider. Otherwise, you may have cardiac arrest if you consume the wrong quantities at the wrong time. The dosage is usually very low and administered only once day due to its potentially dangerous effect on the heart if not taken correctly. Speaking of administration, it is orally consumed, typically after eating a meal. 

The usage of bisoprolol as a treatment for POTS is heavily supported by medical studies. For example, "Efficacy of beta-blockers in the treatment of Postural tachycardia syndrome: A randomized, double-blind, placebo-controlled trial"; this study investigated the effects of bisoprolol in POTS patients. It found that bisoprolol had a significant effect on decreasing heart rate compared to a placebo, especially when the patients were standing. 

Bisoprolol consumption should be avoided by people with bradycardia (the opposite of tachycardia), or people with abnormally slow heart rates. Bisoprolol also constricts airways, so people with Asthma should try to avoid it. Anyone with history of high LDL cholesterol in their blood should also avoid the medicine unless instructed by a healthcare provider, as LDL deposits can make arterial lumen thinner and constrict blood flow and bisoprolol heavily exacerbates that. 

All in all, bisoprolol is a useful yet risky medication to use, and should be only used with a prescription from their doctor, with regular check-ups to ensure safety. 

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