Prazosin and congestive heart failure: short- and long-term therapy.
Reviewed here are the data from 34 patients given prazosin for chronic intractable heart failure. In 13 patients in whom hemodynamics were measured after the fifth 3 mg dose of prazosin was given, no attenuation was found. The cardiac index increased from 1.77 +/- 0.13 to 2.5 +/- 0.13 liters/min/m2 (p less than 0.001), and the pulmonary capillary wedge pressure decreased from 31,46 +/- 1.56 to 23.54 +/- 1.11 mg Hg (p less than 0.001). During long-term follow-up (15.9 +/- 1.5 months) the administration of spironolactone proved to be very useful. Within three months of starting prazosin therapy, none of the 15 patients discharged on a regimen of spironolactone needed readmission for edema, but 11 of the 13 patients discharged without a spironolactone regimen did. The addition of spironolactone or an increase in furosemide to the therapeutic regimen was helpful but a change to hydralazine was not. We concluded that prazosin causes short-term hemodynamic and long-term clinical improvement in patients with intractable heart failure; that spironolactone helps to prevent clinical attenuation but that more detailed studies are required to better characterize the attenuation to vasodilators seen in patients with congestive heart failure.
D000368:Aged; D004232:Diuretics / Q000627:therapeutic use; D005260:Female; D006333:Heart Failure / Q000188:drug therapy* / Q000503:physiopathology; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D011224:Prazosin / Q000008:administration & dosage* / Q000627:therapeutic use; D011799:Quinazolines / Q000008:administration & dosage*; D013997:Time Factors; D014665:Vasodilator Agents / Q000008:administration & dosage* / Q000627:therapeutic use
D004232:Diuretics; D011799:Quinazolines; D014665:Vasodilator Agents; D011224:Prazosin