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Document Details : Title: Safety and efficacy of doxazosin as an 'add-on' antihypertensive therapy in mild to moderate heart failure patients Author(s): R. Spoladore , R. Roccoforte , G. Fragasso , C. Gardini , A. Palloshi , A. Cuko , F. Arioli , A. Salerno , A. Margonato Journal: Acta Cardiologica Volume: 64 Issue: 4 Date: 2009 Pages: 485-491 DOI: 10.2143/AC.64.4.2041613 Abstract : 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. Methods and 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. |
