Doxazosin and congestive, heart failure

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 r isk of CHF to be twice as high with doxazosin than with chlorthalidone. Alt hough some questions remain regarding the diagnosis and mortality of CHF in the doxazosin arm and regarding the risk of dying from malignancy in the d iuretic arm of ALLHAT, drugs used to treat hypertension should lower the CH F risk. Therefore, until ironclad safety data are provided, doxazosin, and probably all alpha-blockers, should no longer be used as first-line antihyp ertensive therapy. (J Am Coll Cardiol 2001;38:1295-6) (C) 2001 by the Ameri can College of Cardiology.