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Comparative Effects of Doxazosin and Carvedilol on Clinical Status and Left Ventricular Function in Hypertensive Patients with Mild Heart Failure

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Abstract

Introduction: β-Blockers have been shown to be effective in the treatment of both arterial hypertension and heart failure. However, slow titration of β-blockers over several weeks and rigorous supervision are essential to minimise antiadrenergic adverse effects in patients with heart failure. α1-Blockers are well tolerated and effectively lower blood pressure by reducing peripheral resistance.

Patients and methods: This study assessed changes in left ventricular function and quality of life in hypertensive patients with mild heart failure treated with enalapril and furosemide combined with a β-blocker with peripheral vasodilating activity (carvedilol) or an α-blocker (doxazosin), over a 1-year period. Sixty patients aged 45–65 years with untreated essential arterial hypertension and mild heart failure were randomised to receive enalapril + furosemide in combination with carvedilol or doxazosin.

Results: In the carvedilol compared with the doxazosin group, ejection fraction diminished significantly (38% vs 42%, p < 0.05) and quality of life worsened significantly (Minnesota Living Heart Failure score 54 vs 47, p < 0.05) during the first 3 weeks of treatment. Ejection fraction and quality of life had significantly improved from baseline in both groups by 12 months.

Conclusion: Doxazosin in combination antihypertensive therapy rapidly improves clinical status and haemodynamics in hypertensive patients with mild heart failure by reducing afterload. After 1 year, doxazosin and carvedilol improve clinical and haemodynamic parameters.

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Acknowledgements

We thank Michele Malena, Managing Director, for Hesperia Hospital support. The authors have no conflicts of interest that are directly relevant to the content of this study.

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Authors and Affiliations

  1. Dipartimento di Cardiologia Medico-Chirurgica, Hesperia Hospital, Via Arquà 80/a, Modena, Italy

    Fabio Zacà, Alberto Benassi, Giuseppina Santese, Antonietta Schipani & Cosimo Stefanio

  2. Dipartimento di Psicologia, University of Bologna, Bologna, Italy

    Roberto Bolzani & Italo Ghidoni

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  1. Fabio Zacà
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  2. Alberto Benassi
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  3. Roberto Bolzani
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  7. Cosimo Stefanio
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Correspondence to Fabio Zacà.

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Zacà, F., Benassi, A., Bolzani, R. et al. Comparative Effects of Doxazosin and Carvedilol on Clinical Status and Left Ventricular Function in Hypertensive Patients with Mild Heart Failure. High Blood Press Cardiovasc Prev 12, 37–44 (2005). https://doi.org/10.2165/00151642-200512010-00006

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