Benefits and side effects of blood pressure lowering treatment: what was wrong with doxazosin in the ALLHAT?

<p>Abstract</p> <p>The lowering of high blood pressure is supposed to protect target organs from hypertensive damage. The Antihypertensive and Lipid Lowering Treatment to Prevent Heart Attack Trial was designed to compare the cardioprotective properties of three antihypertensives f...

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Main Authors: Gavras Haralambos, Gavras Irene
Format: Article
Language:English
Published: BMC 2001-11-01
Series:Current Controlled Trials in Cardiovascular Medicine
Subjects:
Online Access:http://dx.doi.org/10.1186/cvm-2-6-257
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author Gavras Haralambos
Gavras Irene
author_facet Gavras Haralambos
Gavras Irene
author_sort Gavras Haralambos
collection DOAJ
description <p>Abstract</p> <p>The lowering of high blood pressure is supposed to protect target organs from hypertensive damage. The Antihypertensive and Lipid Lowering Treatment to Prevent Heart Attack Trial was designed to compare the cardioprotective properties of three antihypertensives from different classes (lisinopril, amlodipine and doxazosin) with chlorthalidone. Despite effective blood pressure lowering and a favorable metabolic profile, the doxazosin arm of the trial had a significantly higher relative risk of cardiovascular disease and heart failure compared with the chlorthalidone arm. This article speculates on possible causes for this unexpected result and suggests that the culprit may be accentuation of the vascular effects of vasopressin, which are maximized under α-adrenergic blockade. These findings may have implications for the large number of older men who receive monotherapy with α-blockers for treatment of prostatic symptoms.</p>
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spelling doaj.art-f7cef9d37bfe4f649f89410d773271c22022-12-22T03:25:47ZengBMCCurrent Controlled Trials in Cardiovascular Medicine1468-67082001-11-012625725910.1186/cvm-2-6-257Benefits and side effects of blood pressure lowering treatment: what was wrong with doxazosin in the ALLHAT?Gavras HaralambosGavras Irene<p>Abstract</p> <p>The lowering of high blood pressure is supposed to protect target organs from hypertensive damage. The Antihypertensive and Lipid Lowering Treatment to Prevent Heart Attack Trial was designed to compare the cardioprotective properties of three antihypertensives from different classes (lisinopril, amlodipine and doxazosin) with chlorthalidone. Despite effective blood pressure lowering and a favorable metabolic profile, the doxazosin arm of the trial had a significantly higher relative risk of cardiovascular disease and heart failure compared with the chlorthalidone arm. This article speculates on possible causes for this unexpected result and suggests that the culprit may be accentuation of the vascular effects of vasopressin, which are maximized under α-adrenergic blockade. These findings may have implications for the large number of older men who receive monotherapy with α-blockers for treatment of prostatic symptoms.</p>http://dx.doi.org/10.1186/cvm-2-6-257α<sub>1</sub>-adrenoceptor blockadecoronary constrictionischemic heart diseasevasopressin
spellingShingle Gavras Haralambos
Gavras Irene
Benefits and side effects of blood pressure lowering treatment: what was wrong with doxazosin in the ALLHAT?
Current Controlled Trials in Cardiovascular Medicine
α<sub>1</sub>-adrenoceptor blockade
coronary constriction
ischemic heart disease
vasopressin
title Benefits and side effects of blood pressure lowering treatment: what was wrong with doxazosin in the ALLHAT?
title_full Benefits and side effects of blood pressure lowering treatment: what was wrong with doxazosin in the ALLHAT?
title_fullStr Benefits and side effects of blood pressure lowering treatment: what was wrong with doxazosin in the ALLHAT?
title_full_unstemmed Benefits and side effects of blood pressure lowering treatment: what was wrong with doxazosin in the ALLHAT?
title_short Benefits and side effects of blood pressure lowering treatment: what was wrong with doxazosin in the ALLHAT?
title_sort benefits and side effects of blood pressure lowering treatment what was wrong with doxazosin in the allhat
topic α<sub>1</sub>-adrenoceptor blockade
coronary constriction
ischemic heart disease
vasopressin
url http://dx.doi.org/10.1186/cvm-2-6-257
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