Add‐on therapy with doxazosin in patients with hypertension influences arterial stiffness and albuterol‐mediated arterial vasodilation

What is already known about this subject • Hypertension is associated with increased arterial stiffness and impaired endothelial function. • Arterial vasodilation depends on endothelial function and can be regulated by β 2 ‐adrenergic stimulation. • Doxazosin is a known and potent antihypertensive agent. However, its effects on arterial stiffness and vasodilation have not been fully established. What this study adds Sixteen‐week add‐on antihypertensive therapy with 4 mg of doxazosin extended release daily: • Reduces arterial stiffness. • Improves albuterol‐mediated, i.e. endothelium‐dependent, arterial vasodilation. • Does not influence nitroglycerin‐mediated, i.e. endothelium‐independent, arterial vasodilation. Aims Doxazosin is an antihypertensive agent with largely unknown effects on arterial stiffness and vasodilation. The aim of this study was to determine the effect of the addition of doxazosin extended‐release (ER) to the standard management of hypertension in patients with inadequately controlled blood pressure (BP) on arterial stiffness and arterial vasodilation. Methods Twenty patients with inadequately controlled hypertension were treated with 4 mg doxazosin ER daily for 16 weeks as an adjunct to their existing antihypertensive regimen. Results Doxazosin ER add‐on therapy was associated with significantly reduced systolic ( P < 0.0001) and diastolic ( P = 0.0003) BP, improved arterial stiffness (determined by digital volume pulse analysis ( P = 0.048) and albuterol‐mediated arterial vasodilation ( P = 0.030). Conclusions Add‐on therapy with 4 mg of doxazosin ER daily reduces BP and arterial stiffness and improves arterial vasodilation in response to adrenergic stimulation.