Why the study?
Does doxazosin as a third agent reduce morning and position-related blood pressure in diabetic patients with chronic kidney disease?
Does doxazosin as a third agent reduce morning and position-related blood pressure in diabetic patients with chronic kidney disease?
Doxazosin as a third-line antihypertensive agent effectively lowers morning blood pressure and improves sympathovagal balance without causing significant orthostatic hypotension in diabetic patients with CKD.
Doxazosin may be preferred over diuretics as third-line therapy for morning BP in diabetic CKD without orthostatic risk; extends sympathovagal findings to this high-risk group.
We conducted a prospective study to assess the effects of doxazosin, as the third agent, on morning and position-related blood pressure (BP) in 77 diabetic patients with chronic kidney disease, who were allocated randomly to doxazosin and diuretics groups. Doxazosin decreased morning BP but diuretics could not decrease pre-awakening diastolic BP. Only doxazosin improved sympathovagal balance. Doxazosin and diuretics decreased standing and sitting BP but only doxazosin improved sympathovagal balance regardless of body positions. Doxazosin did not decrease absolute BP changes shortly after standing. In diabetic patients, doxazosin decreased morning BP through improving sympathovagal balance without causing significant orthostatic hypotension (ClinicalTrials.gov number, NCT00295555).
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Yasuda et al. (2014) studied this question.
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