Utility of Prazosin in the Management of Patients with Severe Chronic Congestive Heart Failure

  • M. Packer
Conference paper


Despite many years of use and numerous investigations regarding its clinical efficacy, the utility of prazosin in the management of severe chronic heart failure remains undefined. Initial reports indicated that the drug produced marked increases in cardiac output and decreases in left ventricular filling pressure and systemic vascular resistance [11], and these benefits were accompanied by long-term amelioration of dyspnea and fatigue [1]. Unfortunately, these initial reports largely evaluated only the hemodynamic effects of first doses of prazosin; subsequent reports indicated that repeated administration of the drug was accompanied by a rapid loss of hemodynamic efficacy, such that there was no notable effect seen after 48h of continuous administration [12]. The importance of this short-term hemodynamic “tachyphylaxis” remained largely unknown, however, since numerous reports indicated that the drug produced long-term hemodynamic and clinical benefits [1, 3, 5, 8, 9]. These investigators, however, did not keep the dose of concomitantly administered diuretics constant and thus could not distinguish between the hemodynamic benefits attributable to prazosin from those resulting from changes in diuretic therapy. Previous reports also did not generally withdraw prazosin at the end of the trial in order to determine whether or not the drug exerted persistent long-term effects.


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Copyright information

© Springer-Verlag Berlin Heidelberg 1986

Authors and Affiliations

  • M. Packer
    • 1
  1. 1.Division of CardiologyThe Mount Sinai Medical CenterNew YorkUSA

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