CONCURRENT ALPH(1), ADRENERGIC-BLOCKADE AND ANGIOTENSIN-CONVERTING ENZYME-INHIBITION IN THE TREATMENT OF CONGESTIVE-HEART-FAILURE

We tested the hypothesis that concurrent inhibition of the renin angio tensin system by enalapril (5 mg) and the sympathetic nervous system b y alpha(1) adrenergic blockade (prazosin 1 mg) will be superior to ena lapril alone in 17 patients with heart failure on standard therapy, in a single blind, placebo-controlled, randomized parallel group study f or 4 weeks. Enalapril alone induced a significant increase in exercise time from 499+/-412 s to 707+/-608 s (P<0.05, ANOVA), but the increas e induced by the enalapril+prazosin combination was significantly grea ter (P<0.025, MANOVA) from 214+/-271 to 1007+/-784 s as was the increa se in creatinine clearance (P<0.05).