Doxazosin versus atenolol: a randomized comparison of calculated coronary heart disease risk reduction.
Doxazosin is a selective alpha 1-inhibitor for the reduction of calculated coronary heart disease (CHD) risk in hypertensive patients. Atenolol, although a widely used beta-blocker, appears to adversely affect blood lipids by increasing triglycerides and decreasing high-density lipoprotein (HDL) cholesterol. The aim of our study was to compare doxazosin and atenolol for their therapeutic efficacy in reducing CHD risk (decrease in blood pressure and effect on lipid distribution) and toleration. Patients with mild-to-moderate hypertension were randomized into two groups of 20 patients to receive once-daily atenolol (100 mg) or doxazosin (2 to 8 mg) for 8 weeks. Doxazosin was as effective as atenolol in reducing supine and standing blood pressure. Unlike atenolol, doxazosin did not produce a marked bradycardia. Doxazosin therapy produced favorable modifications in plasma lipid profiles by decreasing triglycerides and total cholesterol and by increasing HDL cholesterol and HDL/total cholesterol ratio. A reverse in this lipid profile was seen with atenolol. Therefore doxazosin may reduce calculated CHD risk more effectively than atenolol, based on the Framingham equation.
Mazzola
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C
Department of Cardiology and Pathology, INRCA-Istituto di Ricovero e Cura a Carrattere Scientifico, Casatenovo, Italy.
Guerrasio
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E
D000293:Adolescent; D000317:Adrenergic alpha-Antagonists / Q000009:adverse effects / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001262:Atenolol / Q000009:adverse effects / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D003327:Coronary Disease / Q000517:prevention & control*; D017292:Doxazosin; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D011224:Prazosin / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D011897:Random Allocation; D012306:Risk
D000317:Adrenergic alpha-Antagonists; D000959:Antihypertensive Agents; D008055:Lipids; D001262:Atenolol; D017292:Doxazosin; D011224:Prazosin