Doxazosin in the treatment of patients with mild or moderate hypertension and mild or moderate renal insufficiency.

The antihypertensive efficacy and safety of doxazosin, a selective alpha 1-inhibitor, were assessed in 23 hypertensive patients with renal insufficiency. The study involved three phases: (1) a 2-week baseline period, (2) a 10-week period during which patients received doxazosin, 1 to 16 mg, once daily, and (3) a 4-week maintenance period. After 14 weeks of active treatment, systolic/diastolic blood pressures of efficacy evaluable patients were reduced by 8.9/9.2 and 4.6/9.1 mm Hg to final values of 153/90 and 149/91 mm Hg in the supine and standing positions, respectively. The mean dose of the efficacy evaluable patients was 9.8 mg/day. Eleven patients experienced one or more side effects, most of which were mild or moderate and disappeared or were tolerated with continued therapy. No clinically significant laboratory changes were apparent, and no trends were observed with regard to organ systems or correlations with dose or duration of treatment. There were no significant differences in serum creatinine levels between baseline and final visits. The overall lipid profile indicated a decrease in total cholesterol with increases in high-density lipoprotein cholesterol and the high-density lipoprotein/total cholesterol ratio. From baseline to final visit there was a highly significant reduction of 19% (p less than 0.05) in calculated risk scores for coronary heart disease on the basis of the Framingham equation.