Safety and efficacy of doxazosin as an "add-on" antihypertensive therapy in mild to moderate heart failure patients.
OBJECTIVE
Doxazosin treatment has been discouraged in hypertensive patients in order to prevent heart failure (HF) development. However, this drug is still prescribed as an "add-on" medication to achieve a better blood pressure (BP) control. The aim of this study was to evaluate the safety and efficacy of doxazosin as an "add-on" medication in HF patients with uncontrolled hypertension.


RESULTS
We reviewed our HF clinic files to collect patient variables recorded at baseline and during follow-up visits in patients receiving, or not, doxazosin. We compared HF-related hospitalization rates and all-cause and cardiovascular mortality rates between patients on doxazosin and those not on doxazosin. We constructed cumulative risk curves for time to first event (HF-related hospitalization and/or death) for both groups of patients. Fifty-two HF patients had been prescribed doxazosin. At baseline, several relevant variables were unevenly distributed between patients receiving doxazosin and those not receiving doxazosin (N=122), such as left ventricular ejection fraction (LVEF) and NYHA class. HF-related hospitalization and death rates were similar between patients on doxazosin and those not on doxazosin at the end of the follow-up. Even after adjustment for all potentially confounding variables, doxazosin was not associated with HF-related hospitalization and/or death. Doxazosin significantly reduced BP, but did not affect NYHA class.


CONCLUSIONS
Doxazosin, "on top" of other antihypertensive treatments was safe and effective, and did not appear to be associated with HF-related hospitalization and mortality rates in our patients with mild/moderate HF.
Spoladore
Roberto
R
Cardiothoracic and Vascular Department, Clinical Cardiology, Heart Failure Clinic, Istituto Scientifico San Raffaele, Milan, Italy. spoladore.roberto@hsr.it
Roccaforte
Rosa
R
Fragasso
Gabriele
G
Gardini
Chiara
C
Palloshi
Altin
A
Cuko
Amarild
A
Arioli
Francesco
F
Salerno
Anna
A
Margonato
Alberto
A
D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D017292:Doxazosin / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000401:mortality / Q000503:physiopathology*; D006760:Hospitalization; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy*; D008297:Male; D013318:Stroke Volume
D000959:Antihypertensive Agents; D017292:Doxazosin