Acute Hemodynamic and Long‐Term Clinical Effects of Prazosin in the Treatment of Chronic Congestive Heart Failure

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Abstract
The effect of prazosin in congestive heart failure was assessed in 10 patients (age 39--69) years) with ischemic heart disease or cardiomyopathy in functional class II-IV (NYHA). All patients were treated with digitalis and diuretics in optimal doses. Mean (+/- S.E.M.) cardiac index (CI) was 2.2 +/- 0.2 l/min/m2 before and 2.3 +/- 0.1 one hour after oral administration of 2--4 mg prazosin (given as tablets) (p less than 0.10). Mean pulmonary capillary wedge pressure (PWP) fell from 24 +/- 4 to 20 +/- 4 mmHg (p greater than 0.10). Prazosin seemed to have a more beneficial effect on patients with markedly elevated PWP or reduced CI before prazosin administration. The effect of prazosin on heart rate and systolic blood pressure was insignificant. During a follow-up period of 1--20 months (mean 7.3), 2 of 7 patients treated with prazosin (2--4 mg daily) improved their clinical condition, one patient was unchanged and 4 patients died in progressive cardiac failure. The results indicate that some patients with severe heart failure may benefit from prazosin when conventional treatment has failed.