Comparison of haemodynamic effects of oral hydralazine and prazosin hydrochloride in patients with chronic congestive heart failure.

Abstract

suMMARY The comparative haemodynamic effects of oral prazosin hydrochloride and hydralazine were evaluated in 11 patients with chronic congestive heart failure.The maximum total dose of prazosin received by an individual varied up to 25 mg. Ten patients received a maximum of 75 mg and one received 50 mg of hydralazine at six-hour intervals. There was no significant change in heart rate with either drug. Decrease in mean arterial and left ventricular filling pressures were modest and similar with both agents. With prazosin, the average cardiac index increased 20 per cent and systemic vascular resistance decreased 20 per cent. By contrast, hydralazine increased cardiac index by 58 per cent and decreased systemic vascular resistance by 40 per cent. The increase in stroke work and stroke volume indices was significantly greater with hydralazine than with prazosin.These findings suggest that in some patients with severe chronic congestive heart failure, improvement in left ventricular performance may be greater with hydralazine than with prazosin.

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

“…The underlying cardiac diseases in our patients were ischemic heart disease and cardiomyopathy as in other reports ( 1 , 8, I I , 12). Although higher doses have been administered in some studies (8, 12), a favourable effect of prazosin in doses comparable to ours has been demonstrated ( I , 6,11,14). It is, however, noteworthy that we administered prazosin as tablets whereas others have mostly used capsules ( I , 14).…”

Pediatric Cardiac Intensive Care Society 2014 Consensus Statement

“…Agents that selectively vasodilate the arterial resistance vessels increase SV and CO but have little if any impact on ventricular filling pressures and the degree of congestion (2,3). Agents that increase venous capacitance and reduce ventricular afterload significantly reduce ventricular diastolic volume and pressure and the degree of congestion while increasing SV and CO (3).…”