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VIEWPOINT

Doxazosin and congestive heart failure

^a Department of Internal Medicine, Section on Hypertensive Diseases, Ochsner Clinic and Alton Ochsner Medical Foundation, New Orleans, Louisiana, USA

Manuscript received June 7, 2001; revised manuscript received July 12, 2001, accepted August 1, 2001.

^* Reprint requests and correspondence: Dr. Franz H. Messerli, Ochsner Clinic, 1514 Jefferson Highway, New Orleans, LA 70121 USA
fmesserli{at}aol.com

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.

Abbreviations and Acronyms   ACE = angiotensin-converting enzyme   ALLHAT = Antihypertensive and Lipid Lowering Treatment to Prevent Heart Attack Trial   CHF = congestive heart failure

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