Aim. Compare the effectiveness of nebivolol and sotalol in patients with hypertensive disease (HD) and ventricular arrhythmias (VA) taking into account its effect on regulatory adaptive status (RAS). Materials and methods. 49 patients with HD of stages II-III and VA of grade I-IV based on the В.Lown grading system, II-III groups based on J.Bigger grading system took part in the research, they were randomized into two groups for treatment with nebivolol (6,9±1,8 mg/day) or sotalol (159,1±47,4 mg/day). As part of combination therapy, patients were administered lisinopril (13,9±3,7 mg/day and 13,7±4,5 mg/day), acetylsalicylic acid when required (90,0±14,6 and 95,0±16,2 mg/day), atorvastatin (18,7±4,1 mg/day and 15,6±4,9 mg/day), respectively. Initially and 6 months after therapy, the following was done: quantitative assessment of RAS (by cardio-respiratory synchronism test), echocardiography, triplex scanning of common carotid arteries, treadmill test, six-minute walk test, all-day monitoring of blood pressure and electrocardiogram, subjective assessment of quality of life. Results. Both drug regimens comparably improved structural and functional condition of the heart, increased controlled arterial hypertension, effectively suppressed ventricular arrhythmia, improved the quality of life. Nebivolol positively affected the RAS and increased exercise tolerance more. Conclusion. In patients with HD of stages II-III and VA as part of combination therapy the use of nebivolol may be preferable to sotalol due to its positive impact on the RAS.