Doxazosin and congestive heart failure.
Congestive heart failure (CHF) is the most devastating cardiac sequella of long-standing hypertension. Recent data from the Antihypertensive and Lipid Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) have shown the risk of CHF to be twice as high with doxazosin than with chlorthalidone. Although some questions remain regarding the diagnosis and mortality of CHF in the doxazosin arm and regarding the risk of dying from malignancy in the diuretic arm of ALLHAT, drugs used to treat hypertension should lower the CHF risk. Therefore, until ironclad safety data are provided, doxazosin, and probably all alpha-blockers, should no longer be used as first-line antihypertensive therapy.
Messerli
F H
FH
Department of Internal Medicine, Section on Hypertensive Diseases, Ochsner Clinic and Alton Ochsner Medical Foundation, New Orleans, Louisiana 70121, USA. fmesserli@aol.com
D000317:Adrenergic alpha-Antagonists / Q000009:adverse effects*; D016907:Adverse Drug Reaction Reporting Systems; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000009:adverse effects*; D002423:Cause of Death; D004232:Diuretics / Q000627:therapeutic use; D017292:Doxazosin / Q000009:adverse effects*; D004359:Drug Therapy, Combination; D006333:Heart Failure / Q000139:chemically induced* / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000188:drug therapy*; D009017:Morbidity; D009369:Neoplasms / Q000139:chemically induced / Q000401:mortality; D018579:Patient Selection; D011379:Prognosis; D012107:Research Design / Q000592:standards; D012307:Risk Factors; D012449:Safety; D016019:Survival Analysis
D000317:Adrenergic alpha-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D004232:Diuretics; D017292:Doxazosin