In this study we evaluated the effects of once-daily administration of oral
doxazosin in patients with chronic
congestive heart failure (CHF). After a stabilization period of at least 2 weeks with digitalis and
diuretics, 73 patients with chronic CHF were randomized to receive additionally either
doxazosin or placebo in double-blind fashion. Patients underwent weekly dose adjustments with increasing doses of
doxazosin (1, 2, 4, 8, and 16 mg daily) or placebo for 5 weeks, and 67 were evaluated for 12 additional weeks on maximally tolerated doses of blinded study drugs. Treatment groups were evaluated with respect to symptoms of
heart failure, indexes of quality of life and left ventricular function, frequency and type of
arrhythmia, adverse events, and mortality rates.
Doxazosin (11.9 +/- 0.9 mg) given once daily produced a favorable trend in the investigators' and patients' assessments of symptomatic change.
Doxazosin was associated with a significantly higher level of voluntary submaximal exercise and a favorable trend on left ventricular ejection fraction (increase of 9.8% of the baseline value vs 2.7% with placebo; p = NS). During the 3-month steady-dosing period, patients treated with
doxazosin had a significant (p less than 0.004) reduction in ventricular arrhythmias and significantly fewer morbid and mortal
cardiac events (including episodes of worsening
heart failure severe enough to prompt discontinuation of the study,
myocardial infarction, and death).
Doxazosin was well tolerated, producing no major side effects and only a slightly higher frequency of minor treatment-related side effects compared with placebo (p = NS).(ABSTRACT TRUNCATED AT 250 WORDS)