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Supports avoiding doxazosin in older hypertensives due to heart failure risk; challenges alpha-blocker use as initial therapy.
The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) is a large, randomized double-blind study comparing four antihypertensive agents (chlorthalidone, doxazosin, amlodipine, and lisinopril) in hypertensive patients older than 55 years. The doxazosin arm was terminated early, when the trial's safety and monitoring board noted a twofold higher incidence of congestive heart failure in patients receiving doxazosin than in those receiving chlorthalidone (8.13% vs 4.45% at 4 years, P < .001).
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Donald G. Vidt (2000) studied this question.
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