Does oral prazosin provide similar cardiocirculatory improvements compared to nitroprusside in patients with chronic refractory congestive heart failure?
Oral prazosin produces similar favorable hemodynamic effects to nitroprusside in refractory heart failure, suggesting it is an effective vasodilator for long-term ambulatory therapy.
We compared cardiocirculatory actions of nitroprusside (NP) to prazosin (PZ) in eleven chronic coronary patients with refractory congestive heart failure. Each drug equally lowered systemic arterial pressures mildly while heart rate was unaltered. NP decline (P less than .001) in left ventricular filling pressure (28 to 17 mm Hg) and rise (P less than .005) in cardiac index (2.20 to 2.96 L/min/m2) were similar to PZ (30 to 17) and (2.08 to 3.00). PZ and NP equally enhanced cardiac efficiency of stroke work and myocardial oxygen consumption index. Total systemic vascular resistance declined (P less than .001) the same with NP and PZ. Forearm vascular resistance (FVR) and venous tone (FVT) diminished equally with NP and PZ. Similar FVR/FVT percent changes of 0.88 and 0.64 with NP and PZ indicated relatively balanced systemic arteriovenous relaxation. Sinze PZ effects persisted six hours with symptomatic improvement, oral PZ is the best vasodilator for long-term use, extending in-hospital NP-like actions to ambulatory heart failure therapy.
Awan et al. (Sun,) studied this question.
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