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Alpha blockers in hypertension

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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The use of doxazosin compared to that of chlorthalidone in patients with hypertension has been examined as part of the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT).

  • this was a blinded, randomised controlled trial. There was a median follow-up of 3.3 years
  • patients included in the trial were >=55 years of age who had a mean systolic blood pressure >= 140 mmHg or diastolic blood pressure >= 90 mmHg, took medication for hypertension, and had at least one other risk factor for cardiovascular disease; exclusion criteria included stroke, MI or angina in the past 6 months and congestive heart failure; 24, 335 patients were included in the trial
  • patients were allocated to treatment with chlorthalidone (n = 15 268) or doxazosin (n = 9067)
  • this trial revealed that, in high risk hypertensive patients, doxazosin was associated with a higher incidence of stroke cardiovascular disease events, particularly congestive heart failure, than treatment with chlorthalidone


1) The ALLHAT officers and Coordinators for the ALLHAT Collaborative Research Group (2000). Major cardiovascular events in hypertensive patients randomize to doxazosin vs chlorthalidone. The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). JAMA, 283, 1967-75.

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