[The status of prazosin in therapy of chronic heart failure]

Cardiac dysfunction and neurohumoral dysregulation show that the administration of vasodilators is reasonable in a cardiac insufficiency which is therapy-refractory against glycosides and saluretics. The alpha 1-blocker prazosin is a potent substance. On the basis of haemodynamic investigations of 55 patients the acute effects are demonstrated. Depending upon the degree of the cardiac insufficiency and the sympathetic dysregulation--measured at the behaviour of the resistance--the acute effects are convincing in more than 60% of the patients. For the long-term course patients with unequivocal initial improvement are suitable. This group can undergo a satisfactory therapy for a longer time by means of a carefully increased dosage, by corrections of the application of saluretics and by short interruptions of therapy and by the change of the dilator, respectively, or by an additional administration of another vasodilator. In the total spectre of the vasodilators which are administered in cardiac insufficiency prazosin occupies one of the first places.