Prazosin in the initial treatment of arterial hypertension
Luna, R.L.
Arquivos Brasileiros de Cardiologia 47(2): 111-117
1986
ISSN/ISBN: 0066-782X PMID: 3555426 Document Number: 17800
An open noncomparative multicenter study was conducted in order to assess the efficacy and toleration of prazosin as first step therapy in 420 patients with mild to moderate arterial hypertension. The purpose of this study was also to evaluate metabolic changes that might occur due to this drug, since recently lipid and lipoprotein disturbances were observed during the treatment of arterial hypertension using diuretic or beta blockers as first step therapy. The trial consisted of 3 phases: phase I - placebo (2 weeks); phase II - prazosin (5 weeks) 0.5-5.0 mg/bid; phase III - prazosin plus chlorthalidone 50 mg/day or propranolol 80 240 mg/day (4 weeks). Clinical evaluations were performed weekly, and by the end of phases I, II and III laboratory tests were made, including a lipid and lipoprotein profile in five centers. A significative (p < 0.05) reduction of diastolic and systolic blood pressure was observed both in supine and orthostatic position. After 5 weeks with prazosin, 79% of the patients had their blood pressure levels controlled. The average daily dose given was 4.75 mg, and the average period for blood pressure control was 2.7 weeks. Laboratory tests made by the end of phase II reported no significant alteration on biochemical or lipid profiles. Dizziness, palpitation and headache were the most common adverse reactions. Only 5.7% of the patients discontinued treatment due to significant adverse reactions. The author concluded that prazosin, when administered alone and as a drug of first choice, is effective and safe in the treatment of mild to moderate hypertension and has no deleterious effect on lipid and lipoprotein metabolism.
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